Individual
TARA LYNN SIESEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
110 WHITFORD DR, DURHAM, NC 27708-9982
(207) 807-6731
Mailing address
182 CEDAR ELM RD, DURHAM, NC 27713-7262
(207) 807-6731
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2701
NC
Other
Enumeration date
12/19/2021
Last updated
12/19/2021
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