Individual
VICTORIA TAVARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
324 GOLDEN MILE RD, TOWANDA, PA 18848-9230
(772) 301-8828
Mailing address
1750 MILL CREEK RD, LE RAYSVILLE, PA 18829-7780
(772) 301-8828
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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