Individual
TARA MARIE BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6000 N ALLEN RD, PEORIA, IL 61614-3294
(309) 691-1400
Mailing address
6000 N ALLEN RD, PEORIA, IL 61614-3294
(309) 691-1400
(309) 693-3197
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160005312
IL
Other
Enumeration date
10/30/2018
Last updated
01/06/2020
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