Lewinfred A Shack, MDIV, LMT is a
Massage Therapist based in Germantown, Tennessee. Lewinfred A Shack is licensed to practice in Tennessee (license number 4952) and his current practice location is
7622 Poplar Pike, Germantown, Tennessee. He can be reached at his office (for appointments etc.) via phone at
(901) 633-6259.
NPI number for Lewinfred A Shack is 1629514393 and his current mailing address is 2809 Kirby Rd Ste 116, Pmb 121, Memphis, Tennessee. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1629514393.
Healthcare Provider's Profile
| Full Name | Lewinfred A Shack |
|---|
| Gender | Male |
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| Speciality | Massage Therapist |
|---|
| Location | 7622 Poplar Pike, Germantown, Tennessee |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1629514393
- Provider Enumeration Date: 01/18/2017
- Last Update Date: 05/03/2017
Medical Identifiers
Medical identifiers for Lewinfred A Shack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1629514393 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225700000X | Massage Therapist | 4952 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lewinfred A Shack is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Lewinfred A Shack, MDIV, LMT
2809 Kirby Rd Ste 116, Pmb 121,
Memphis, TN 38119-8245
Ph: (901) 633-6259 | Lewinfred A Shack, MDIV, LMT
7622 Poplar Pike,
Germantown, TN 38138-5941
Ph: (901) 633-6259 |
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