Individual
TARYN BAUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
785 WILLIAMS ST # 198, LONGMEADOW, MA 01106-2063
(413) 626-6812
Mailing address
785 WILLIAMS ST # 198, LONGMEADOW, MA 01106-2063
(413) 626-6812
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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