Provider Demographics
NPI:1508891979
Name:GREENE, KAMARI DENISE (PT)
Entity Type:Individual
Prefix:MS
First Name:KAMARI
Middle Name:DENISE
Last Name:GREENE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3980 NEW COVINGTON PIKE
Mailing Address - Street 2:108
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-2500
Mailing Address - Country:US
Mailing Address - Phone:901-937-3200
Mailing Address - Fax:901-383-1738
Practice Address - Street 1:3980 NEW COVINGTON PIKE
Practice Address - Street 2:108
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-2500
Practice Address - Country:US
Practice Address - Phone:901-937-3200
Practice Address - Fax:901-383-1738
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3648544Medicare ID - Type Unspecified