Individual
TARA A CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1950 N POINT BLVD, 516, TALLAHASSEE, FL 32308-4168
(850) 878-8999
Mailing address
1138 E TENNESSEE ST, TALLAHASSEE, FL 32308-6912
(850) 878-8999
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA47562
FL
Other
Enumeration date
11/21/2007
Last updated
11/21/2007
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