Provider Demographics
NPI:1275646564
Name:REHAD MED PHYSICAL THERAPY AND WELLNESS SERVICES, P.C.
Entity Type:Organization
Organization Name:REHAD MED PHYSICAL THERAPY AND WELLNESS SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUINOCOR
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:901-323-1196
Mailing Address - Street 1:2552 POPLAR AVE
Mailing Address - Street 2:SUITE 403
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-3852
Mailing Address - Country:US
Mailing Address - Phone:901-323-1196
Mailing Address - Fax:901-323-1197
Practice Address - Street 1:2552 POPLAR AVE
Practice Address - Street 2:SUITE 403
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-3852
Practice Address - Country:US
Practice Address - Phone:901-323-1196
Practice Address - Fax:901-323-1197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3814OtherPHYSICAL THERAPY LICENSE
TN4215OtherPHYSICAL THERAPY LICENSE