Individual
MRS. TARA MARIE MITCHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
929 E MONTCLAIR ST STE 104, SPRINGFIELD, MO 65807-5068
(417) 888-0808
(417) 888-0811
Mailing address
929 E MONTCLAIR ST STE 104, SPRINGFIELD, MO 65807-5068
(417) 888-0808
(417) 888-0811
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2008020589
MO
Other
Enumeration date
08/06/2008
Last updated
02/05/2009
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