Individual
MRS. TARA LYNN ATANASOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
10 TRI PARK WAY, APPLETON, WI 54914-1658
(920) 831-7942
Mailing address
W6989 ANGEL HILL DR, GREENVILLE, WI 54942-9212
(920) 757-6219
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3011-035
WI
Other
Enumeration date
07/25/2006
Last updated
07/08/2007
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