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Individual

MS. TARAH BURT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
3500 COMANCHE NE STE A-3, ALBUQUERQUE, NM 87017
(505) 238-7615
Mailing address
PO BOX 15376, RIO RANCHO, NM 87174-0376
(505) 238-7615

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6987
NM

Other

Enumeration date
06/25/2013
Last updated
06/25/2013
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