LEWINFRED A SHACK MDIV. LMT NPI 1629514393

NPI Information

  • NPI: 1629514393
  • Provider Name: LEWINFRED A SHACK, MDIV., LMT
  • Classification: Massage Therapist - 225700000X
  • Entity Type: Individual
  • Address: 7622 POPLAR PIKE
    GERMANTOWN, TN
    ZIP 38138
  • Phone: (901) 633-6259

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NPI Details

Lewinfred A Shack, MDIV., LMT is a massage therapist in Germantown, TN. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. Lewinfred A Shack, MDIV., LMT NPI is 1629514393. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7622 POPLAR PIKE
GERMANTOWN, TN
ZIP 38138-941
Phone: (901) 633-6259

The enumeration date for this NPI number is 1/18/2017 and was last updated on 5/3/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225700000XMassage Therapist4952TENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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