Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 3281 | TN |
NPI | 1013365642 |
---|---|
Provider Name | Shaleen Ragha |
First Address | Alpharetta, GA 30022-3491 |
Second Address | Memphis, TN 38104-2127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2016 |
Last Update Date | 24/05/2016 |