Individual
TARA R LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, CHT
Contact information
Practice address
103 W STONE DR, KINGSPORT, TN 37660-3220
(423) 224-5751
Mailing address
103 W STONE DR, KINGSPORT, TN 37660-3220
(423) 224-5751
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
3959
TN
Other
Enumeration date
03/20/2014
Last updated
03/20/2014
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