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Individual

MRS. TARA ANN MERRILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CPO

Contact information

Practice address
1409 YANCEYVILLE STREET, SUITE B, GREENSBORO, NC 27405-6961
(336) 537-3901
(336) 893-9537
Mailing address
1345 WESTGATE CENTER DRIVE, SUITE B, WINSTON SALEM, NC 27103-3041
(336) 546-7165
(866) 403-2483

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
224P00000X
Prosthetist
Primary

Other

Enumeration date
08/25/2023
Last updated
08/28/2024
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