Individual
TARA SZABO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1005 N HICKORY RD, SOUTH BEND, IN 46615-3723
(574) 233-5754
(574) 233-7406
Mailing address
1005 N HICKORY RD, SOUTH BEND, IN 46615-3723
(574) 233-5754
(574) 233-7406
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
99042471
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100351040
—
IN
Enumeration date
07/07/2010
Last updated
07/07/2010
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