Tara Hannah

NPI #1598131195 in Kirtland, New Mexico

Provider Information

NPI Number: 1598131195
Entity Type: Individual
Name: Tara Hannah
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Aug 18, 2015
Last Updated: Aug 18, 2015

Practice Location

Address: 68 ROAD 6118
City: Kirtland
State: New Mexico
ZIP Code: 87417-9319
Phone: (505) 402-6407

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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