Individual
MICHELLE L TABOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFA
Contact information
Practice address
1345 S CREASY LN, SUITE 225, LAFAYETTE, IN 47905
(765) 449-2436
(765) 449-1817
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
00F752
IN
Other
Enumeration date
03/06/2007
Last updated
08/13/2015
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