Provider Demographics
NPI:1659521128
Name:LYMPHATIC THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:LYMPHATIC THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PTA, CLT
Authorized Official - Phone:901-756-9944
Mailing Address - Street 1:275 S WALNUT BEND RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7279
Mailing Address - Country:US
Mailing Address - Phone:901-756-9944
Mailing Address - Fax:901-756-9949
Practice Address - Street 1:275 S WALNUT BEND RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7279
Practice Address - Country:US
Practice Address - Phone:901-756-9944
Practice Address - Fax:901-756-9949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN225100000X
TN3593225200000X
TN350225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty