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Individual

MISS TARA LIN CONWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, ATC, LAT

Contact information

Practice address
100 WELDON BLVD, SANFORD, FL 32773-6132
(407) 708-2674
(407) 708-2142
Mailing address
100 WELDON BLVD, SANFORD, FL 32773-6132
(407) 708-2674
(407) 708-2142

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL2541
FL

Other

Enumeration date
06/23/2009
Last updated
06/23/2009
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