Individual
MRS. RACHEL SIDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6515 POPLAR AVE STE 112, MEMPHIS, TN 38119-4878
(901) 795-1776
(901) 795-1738
Mailing address
6515 POPLAR AVE STE 112, MEMPHIS, TN 38119-4878
(901) 795-1776
(901) 795-1738
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
215
TN
224P00000X
Prosthetist
195
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CPO 03218
ABC
—
Enumeration date
04/11/2017
Last updated
01/16/2019
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