Individual
TARA PRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
215 TOLL GATE RD STE 205, WARWICK, RI 02886-4461
(401) 773-7272
Mailing address
215 TOLL GATE RD, WARWICK, RI 02886-4458
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA01175
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA01175
STATE LICENSE
RI
Enumeration date
07/10/2019
Last updated
07/10/2019
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