Organization
MEMPHIS SPINE AND REHAB CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA SUE PETTY (OFFICE MANAGER)
(901) 751-0939
Entity
Organization
Contact information
Practice address
2645 APPLING RD STE 103, MEMPHIS, TN 38133-5088
(901) 751-0939
(901) 751-0332
Mailing address
7796 WOLF TRAIL CV STE 1022645, MEMPHIS, TN 38138-1782
(901) 751-0939
(901) 751-0332
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q009468
—
TN
Enumeration date
07/15/2014
Last updated
02/25/2020
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