Tara a Thiel Od PA

NPI #1578062410 in St Petersburg, Florida

Provider Information

NPI Number: 1578062410
Entity Type: Organization
Organization Name: Tara a Thiel Od PA
Primary Specialty: Optometrist
Enumeration Date: Feb 6, 2018
Last Updated: Feb 6, 2018

Practice Location

Address: 6901 22ND AVE N
City: St Petersburg
State: Florida
ZIP Code: 33710-3943
Phone: (727) 302-0467

Authorized Official

Name: DR. TARA A THIEL, OD
Title: OWNER
Phone: (727) 302-0467

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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