Memphis Myofascial Release, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2915 Issued in TN

Legal business name

MEMPHIS MYOFASCIAL RELEASE, LLC

Practice address

95 S Main St
#105
Memphis, TN 38103-2944

Phone

(901) 435-6045

Fax

(901) 202-7581

NPI assigned

Sep 28, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Julie A Leigh, OTR/L

Title

Occupational Therapist & Owner

Phone

(901) 435-6045

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321228800000",
    "number": "1013291855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 S MAIN ST",
            "address_2": "#105",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032944",
            "telephone_number": "901-435-6045",
            "fax_number": "901-202-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 S MAIN ST",
            "address_2": "#105",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032944",
            "telephone_number": "901-435-6045",
            "fax_number": "901-202-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS MYOFASCIAL RELEASE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-28",
        "last_updated": "2011-11-14",
        "status": "A",
        "authorized_official_last_name": "LEIGH",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST & OWNER",
        "authorized_official_telephone_number": "901-435-6045",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "2915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Memphis, TN
• Providers in Memphis, TN by specialty
• Occupational Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.