Individual
TARA BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT/ATC
Contact information
Practice address
2012 ROBERT DEDMAN DR, AUSTIN, TX 78712-1505
(512) 471-5513
Mailing address
PO BOX 7399, AUSTIN, TX 78713-7399
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT3764
TX
Other
Enumeration date
11/04/2011
Last updated
11/04/2011
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