Individual
TARA GRECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
217 OLYMPIC DRIVE, JONESBORO, AR 72401
(870) 972-3342
Mailing address
PO BOX 480, STATE UNIVERSITY, AR 72467-0480
(870) 972-3342
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT686
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT686
LICENSED ATHLETIC TRAINER
AR
Enumeration date
08/06/2015
Last updated
08/06/2015
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