Individual
TARA KIGHTLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
442 BRENDA DR, MANSFIELD, OH 44907
(419) 610-5293
Mailing address
442 BRENDA DR, MANSFIELD, OH 44907-1704
(419) 610-5293
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
05819
OH
Other
Enumeration date
02/21/2012
Last updated
02/21/2012
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