MEDICARE: RODNEY NASH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT0000008605	TN

General Provider Information

NPI Number	:	1003266826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODNEY NASH

Provider Business Mailing Address
First Line	:	1859 HARBERT AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38104-5214
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1859 HARBERT AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38104-5214
Country	:	US
Telephone Number	:	901-275-0352
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2016
Last Update Date	:	06/13/2016

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