Individual
DR. TARA KEYA JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
2416 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23454-3993
(757) 422-2000
(757) 422-1151
Mailing address
2416 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23454-3993
(757) 422-2000
(757) 422-1151
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001212
VA
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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