Individual
TARA L GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
41 UNION SQ W STE 811, NEW YORK, NY 10003-3265
(347) 566-1324
Mailing address
3241 32ND ST # 1, ASTORIA, NY 11106-2644
(562) 234-7502
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
007578
NY
171100000X
Acupuncturist
184115
OR
Other
Enumeration date
12/20/2017
Last updated
11/04/2024
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