Individual
MISS TARA A PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED.
Contact information
Practice address
449 E MOUNTAIN RIDGE MHP, WILKES BARRE, PA 18702-8037
(570) 498-1234
Mailing address
449 E MOUNTAIN RIDGE MHP, WILKES BARRE, PA 18702-8037
(570) 498-1234
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/19/2013
Last updated
06/03/2020
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