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Individual

TARA GRUBBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
1600 N COIT RD, RICHARDSON, TX 75080-2899
(469) 593-5206
Mailing address
1600 N COIT RD, RICHARDSON, TX 75080-2899
(469) 593-5206

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
040602046
TX
2255A2300X
Athletic Trainer
Primary
AT3676
TX

Other

Enumeration date
04/17/2018
Last updated
04/17/2018
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