Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 5016 | TN |
NPI | 1114334414 |
---|---|
Provider Name | David Parker Gregory |
First Address | Memphis, TN 38117 |
Second Address | Memphis, TN 38117-5720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2014 |
Last Update Date | 18/07/2014 |