Individual
DR. TARA MARIE KLIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
804 SERVICE ROAD, ROOM D100, EAST LANSING, MI 48824-7062
(517) 353-5053
Mailing address
804 SERVICE ROAD, ROOM D100, EAST LANSING, MI 48824-7062
(517) 353-5053
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5101017398
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851567788
—
MI
Enumeration date
04/30/2008
Last updated
04/13/2012
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