Individual
TARA MARIE HUMPHREYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, CSCS
Contact information
Practice address
1337 LOWER CAMPUS RD, HONOLULU, HI 96822-2312
(808) 956-4537
(808) 956-5717
Mailing address
1337 LOWER CAMPUS RD, HONOLULU, HI 96822-2312
(808) 956-4537
(808) 956-5717
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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