Individual
TARA CLENNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2601 W BROWARD BLVD # 432, FORT LAUDERDALE, FL 33312-1308
(954) 678-9777
(954) 872-1921
Mailing address
1500 N UNIVERSITY DR STE 101, CORAL SPRINGS, FL 33071-6071
(954) 458-1199
(877) 349-0255
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
41778
FL
225100000X
Physical Therapist
Primary
PT41778
FL
2251X0800X
Orthopedic Physical Therapist
Primary
PT41778
FL
Other
Enumeration date
06/25/2024
Last updated
04/30/2026
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