Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT0000008605 | TN |
NPI | 1003266826 |
---|---|
Provider Name | Rodney Nash |
First Address | Memphis, TN 38104-5214 |
Second Address | Memphis, TN 38104-5214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2016 |
Last Update Date | 13/06/2016 |