Individual
TARA R HUTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
5150 VILLAGE SQUARE DR, PADUCAH, KY 42001-9060
(270) 415-9575
(270) 415-9576
Mailing address
PO BOX 7208, PADUCAH, KY 42002-7208
(270) 415-9575
(270) 415-9576
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT002077
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000288348
ANTHEM
KY
01
—
1109154002
CIGNA
KY
Enumeration date
11/08/2005
Last updated
12/02/2010
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