Individual
DR. TARA SUE PRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1900 STATE ST, SUITE 2, BETTENDORF, IA 52722-5195
(563) 323-1551
Mailing address
1900 STATE ST, SUITE 2, BETTENDORF, IA 52722-5195
(563) 323-1551
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
06817
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39899
BLUE CROSS BLUE SHIELD
—
Enumeration date
03/14/2006
Last updated
10/23/2012
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