Provider Demographics
NPI:1659481448
Name:BARAWID, RESA SATURDAY (PT)
Entity Type:Individual
Prefix:MRS
First Name:RESA
Middle Name:SATURDAY
Last Name:BARAWID
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 171422
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38187-1422
Mailing Address - Country:US
Mailing Address - Phone:901-388-4474
Mailing Address - Fax:901-388-4486
Practice Address - Street 1:9160 HIGHWAY 64
Practice Address - Street 2:SUITE 3
Practice Address - City:LAKELAND
Practice Address - State:TN
Practice Address - Zip Code:38002-4766
Practice Address - Country:US
Practice Address - Phone:901-388-4474
Practice Address - Fax:901-388-4486
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT 0002435225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3646399Medicare PIN