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Individual
TARA WOODWARD
Active
Individual
TARA WOODWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 21784
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA 21784
PTA LICENSE
FL
Enumeration date
12/02/2015
Last updated
10/13/2016
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