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Individual

ALLEN K RAICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1121 POPLAR VIEW LN N STE 2, COLLIERVILLE, TN 38017-9339
(901) 853-3015
(901) 853-3015
Mailing address
1121 POPLAR VIEW LN N STE 2, COLLIERVILLE, TN 38017-9339
(901) 853-3015
(901) 853-3015

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
TNDPM228
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3351106
TN
01
4106735
BLUE SHIELD
TN
01
621362430
TAX ID
TN
01
P00276068
RAILROAD MEDICARE
TN
Enumeration date
09/20/2006
Last updated
03/04/2014
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