Individual
TARIK N CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
909 N DALE MABRY HWY, TAMPA, FL 33609-1251
(813) 978-9700
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3706
FL
Other
Enumeration date
01/03/2018
Last updated
01/03/2018
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