Organization
STEPHEN D RAINES D.P.M.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY W RAINES (PRACTICE MANAGER)
(731) 885-0220
Entity
Organization
Contact information
Practice address
1901 COOK ST, DYERSBURG, TN 38024-1882
(731) 286-2139
Mailing address
1415 E REELFOOT AVE, UNION CITY, TN 38261-5812
(731) 885-0220
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
DPM217
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962534677
DME
TN
05
—
3350894
—
TN
Enumeration date
02/05/2008
Last updated
02/05/2008
Update your record
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