Individual
MS. TARA NICOLE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1140 CENTRAL AVE APT 3, RIVERSIDE, CA 92507-6265
(310) 728-9001
Mailing address
PO BOX 56391, RIVERSIDE, CA 92517-1291
(310) 728-9001
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
64978
CA
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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