Mary Cristine Bader

Individual provider Active NPI Physical Therapy Assistant · Cordova, TN

NPI 1023274339 · NPPES record last updated Aug 6, 2008

Key facts

NPI
1023274339
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2590 (TN)
Practice address
955 N Germantown Pkwy
Cordova, TN 38018-6215
Phone
(901) 752-5998
Fax
(901) 751-9799
NPI assigned
Aug 6, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2590TNMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2590 TN Yes

Addresses

Primary practice location

955 N Germantown Pkwy
Cordova, TN 38018-6215

Mailing address

955 N Germantown Pkwy
Cordova, TN 38018-6215
Phone (901) 752-5998

Other providers in Cordova, TN

All providers in Cordova, TN · Physical Therapy Assistant in Tennessee

Sources for this page

Verify at the official NPI Registry.