Individual
TARA LYNN KNOTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
5972 UNIVERSITY BLVD W, JACKSONVILLE, FL 32216-4912
(904) 419-5670
Mailing address
5972 UNIVERSITY BLVD W, JACKSONVILLE, FL 32216-4912
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026625600
—
FL
Enumeration date
12/10/2020
Last updated
12/10/2020
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