Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 5442 | TN |
NPI | 1063047173 |
---|---|
Provider Name | Shandi Rakowsky |
First Address | Oakland, TN 38060-5175 |
Second Address | Memphis, TN 38120-4038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2020 |
Last Update Date | 18/11/2021 |