Healthcare Provider Details

I. General information

NPI: 1942800081
Provider Name (Legal Business Name): TARA LEE DUNN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2020
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 SUMMER ST
TAUNTON MA
02780-3479
US

IV. Provider business mailing address

233 THELMA AVE
SOMERSET MA
02726-2931
US

V. Phone/Fax

Practice location:
  • Phone: 508-822-4885
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: