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Individual

MRS. TARA K. MOON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, PT

Contact information

Practice address
3715 W 133RD ST, LEAWOOD, KS 66209-3347
(913) 593-5939
Mailing address
14068 W 147TH PL, OLATHE, KS 66062-8869
(913) 593-5939

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
11-03207
KS

Other

Enumeration date
07/28/2005
Last updated
11/03/2016
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