Individual
TARA BETH GOCHENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC/L
Contact information
Practice address
1336 HIGHWAY 54 W, BLDG 500, FAYETTEVILLE, GA 30214-4535
(770) 461-6142
(770) 461-6271
Mailing address
1336 HIGHWAY 54 W, BLDG 500, FAYETTEVILLE, GA 30214-4535
(770) 461-6142
(770) 461-6271
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000650
GA
Other
Enumeration date
07/26/2005
Last updated
04/03/2008
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