Individual
TARA BOATWRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8 RIVER OAKS WAY, PALM COAST, FL 32137-3281
(386) 585-0365
Mailing address
8 RIVER OAKS WAY, PALM COAST, FL 32137-3281
(386) 585-0365
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
FL
146N00000X
Basic Emergency Medical Technician
Primary
305728
FL
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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