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Tasheka L Jackson
Prosthetic/Orthotic Supplier in Memphis, Tennessee
NPI 1457004863

Tasheka L Jackson is a Prosthetic/Orthotic Supplier based in Memphis, TN. Tasheka L Jackson practices in Memphis, TN. The NPI Number for Tasheka L Jackson is 1457004863 and holds a License No. (Tennessee).

The current practice location address for Tasheka L Jackson is 4204 E Mallory Ave, Memphis, TN and can be reached out via phone at 901-649-0305 and via fax at 601-340-9588.

Location: 4204 E Mallory Ave, Memphis, TN, 38111-7819
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1457004863
Provider Name
Tasheka L Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
4204 E Mallory Ave, Memphis, TN, 38111-7819
Phone Number
901-649-0305
Fax Number
601-340-9588
Provider Enumeration Date
01/27/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4204 E Mallory Ave
City
Memphis
State
Tennessee
Zip
38111-7819
Phone Number
901-649-0305
Fax Number
601-340-9588
person
Provider Business Mailing Address Details
Address
4204 E Mallory Ave
City
Memphis
State
Tennessee
Zip
38111-7819
Phone Number
901-649-0305
Fax Number
601-340-9588
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
332BC3200X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
()
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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