Individual
MS. TARA FELICIA PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1149 GEORGE W CRAWFORD DR, AUGUSTA, GA 30909-0081
(706) 951-9097
Mailing address
1149 GEORGE W CRAWFORD DR, AUGUSTA, GA 30909-0081
(706) 951-9097
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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