Individual
TARA BRISSON BIRCHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
300 BLAKE BLVD, PINEHURST, NC 28374-8474
(910) 215-5710
Mailing address
112 CLIFTON ST, PEMBROKE, NC 28372-7881
(910) 258-6088
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1674
NC
Other
Enumeration date
03/12/2014
Last updated
03/12/2014
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