Individual
TARA HARTMAN-GUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
421 CANYON TRL, CHARLOTTE, NC 28270-5315
(704) 366-6835
Mailing address
421 CANYON TRL, CHARLOTTE, NC 28270-5315
(704) 366-6835
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
7295151
ND
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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