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Physicians Neuromusculoskeletal Medicine, Sports Medicine

Provider NPI: 1801847025

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
1995 HIGHWAY 51 S SUITE 102 COVINGTON, TN 38019-3635 US
Tel: 901-476-3424  Fax: 901-475-3696

Business Mailing Address:
5192 BLACKWELL RD  MEMPHIS, TN 38134-3104 US
Tel: 901-476-3424  Fax: 901-475-3696

NPI Information:
NPI: 1801847025
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Neuromusculoskeletal Medicine, Sports Medicine

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 204C00000X





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