Individual
TARA LEE HOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 N MAIN ST, BRISTOL, CT 06010-8122
(888) 793-3500
Mailing address
5 SPRING LN APT J7, FARMINGTON, CT 06032-3382
(860) 921-6028
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
163878
CT
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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