Individual
SEQUOYHA RAECHELLE OUTLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
176C W UNIVERSITY PKWY # C, JACKSON, TN 38305-1616
(731) 300-4950
(731) 300-4951
Mailing address
176C W UNIVERSITY PKWY # C, JACKSON, TN 38305-1616
(731) 300-4950
(731) 300-4951
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
12410
TN
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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