Individual
SHARON HACKWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3425 WINDY HOLLOW CIR, MEMPHIS, TN 38118-4002
(901) 608-0380
Mailing address
3425 WINDY HOLLOW CIR, MEMPHIS, TN 38118-4002
(901) 518-3244
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306383302
—
TN
Enumeration date
01/27/2017
Last updated
05/10/2018
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