Individual
MISS TIESE A CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2271 DUNDEE DR, XENIA, OH 45385-4962
(504) 237-2014
Mailing address
2271 DUNDEE DR, XENIA, OH 45385-4962
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
2255A2300X
—
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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