Individual
MRS. SUZANNE TARA AVANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4656 US HIGHWAY 117 S, BURGAW, NC 28425-3793
(910) 470-2278
Mailing address
4656 US HIGHWAY 117 S, BURGAW, NC 28425-3793
(910) 470-2278
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
2058
NC
Other
Enumeration date
07/02/2009
Last updated
07/02/2009
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