MEDICARE: MRS. LINDA F REDDICK CFM

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	1744P3200X	Prosthetics Case Management	CFM01423	TN

General Provider Information

NPI Number	:	1609950856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA F REDDICK CFM

Provider Business Mailing Address
First Line	:	2838 HICKORY HILL RD
Second Line	:	32
City	:	MEMPHIS
State	:	TN
Zip	:	38115-2173
Country	:	US
Telephone Number	:	901-546-7572
Fax Number	:	901-546-7572

Provider Business Practice Location Address
First Line	:	2838 HICKORY HILL RD
Second Line	:	32
City	:	MEMPHIS
State	:	TN
Zip	:	38115-2173
Country	:	US
Telephone Number	:	901-546-7572
Fax Number	:	901-546-7572

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/08/2007

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