Individual
TARA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(337) 531-3129
Mailing address
1585 3RD ST, FORT POLK, LA 71459-5102
(337) 531-3129
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1778
LA
Other
Enumeration date
02/23/2012
Last updated
02/23/2012
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