Individual
MRS. TARA OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5206 SPINNING WHEEL DR, GRAND BLANC, MI 48439-4228
(810) 922-9695
Mailing address
5206 SPINNING WHEEL DR, GRAND BLANC, MI 48439-4228
(810) 922-9695
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
4704296571
MI
Other
Enumeration date
12/01/2013
Last updated
12/01/2013
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