Individual
TARA K BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
1006 RIDGEVIEW DR, ORWIGSBURG, PA 17961-2332
(570) 807-6420
Mailing address
621 2ND ST, PORT CARBON, PA 17965-1431
(570) 640-8360
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/21/2014
Last updated
02/21/2014
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