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Individual

TARENA MARSHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC

Contact information

Practice address
403 MAIN ST, GRAMBLING, LA 71245-2715
(601) 382-5170
Mailing address
110 FAITH LN, MENDENHALL, MS 39114-5831
(601) 382-5170

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
320938
LA

Other

Enumeration date
06/05/2023
Last updated
06/05/2023
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