Individual
MS. TARA ANNE USIAK MCCONOHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT ATC
Contact information
Practice address
180 S FRONTAGE RD W, VAIL, CO 81657-5038
(970) 476-1100
Mailing address
E4543 483RD AVE, MENOMONIE, WI 54751-5481
(715) 308-4644
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1797
WI
2255A2300X
Athletic Trainer
Primary
AT.0002465
CO
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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