Provider Demographics
NPI:1639893001
Name:MSK GROUP, PC
Entity type:Organization
Organization Name:MSK GROUP, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSCITTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-641-3000
Mailing Address - Street 1:6077 PRIMACY PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5754
Mailing Address - Country:US
Mailing Address - Phone:901-259-1673
Mailing Address - Fax:901-259-7637
Practice Address - Street 1:1582 GREEN T RD STE C
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-9475
Practice Address - Country:US
Practice Address - Phone:901-259-1600
Practice Address - Fax:901-259-1698
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MSK GROUP, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-29
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy