1316498082 NPI number — MRS. KAREN PRYOR PHYSICAL THERAPY A

Table of content: MRS. KAREN PRYOR PHYSICAL THERAPY A (NPI 1316498082)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316498082 NPI number — MRS. KAREN PRYOR PHYSICAL THERAPY A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRYOR
Provider First Name:
KAREN
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHYSICAL THERAPY A
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LYNN
Provider Other First Name:
KAREN
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHYSICAL THERAPIST A
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1316498082
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7516 SPLIT RAIL CV
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEMPHIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38125-3052
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
409-332-1618
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5200 KELLER SPRINGS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75248-2723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-661-0883
Provider Business Practice Location Address Fax Number:
972-661-0883
Provider Enumeration Date:
10/18/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174H00000X , with the licence number:  447 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com