NPI 1457004863

Tasheka L Jackson

Practitioner Prosthetic/Orthotic Supplier Memphis, TN

Practice location

Address: 4204 E Mallory Ave, Memphis, TN 38111-7819
Phone: (901) 649-0305
Fax: (601) 340-9588

Registered specialties (2)

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

Other Prosthetic/Orthotic Supplier providers in Tennessee →

Customized Equipment (DME)

Suppliers Taxonomy 332BC3200X

Other Durable Medical Equipment & Medical Supplies providers in Tennessee →

Registry record

NPI: 1457004863
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Jan 2022
Record last updated: 27 Jan 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.