Individual
TARA LAZURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 E 34TH ST, JOPLIN, MO 64804-4310
(417) 781-1737
Mailing address
2700 E 34TH ST, JOPLIN, MO 64804-4310
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2011031968
MO
Other
Enumeration date
10/12/2011
Last updated
10/12/2011
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