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General NPI Number Information
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NPI Number | 1275304156
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Entity Type | Organization
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Legal Business Name | TARA THE RD LLC
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Dates
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Enumeration Date | 01/10/2024
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 7124 MICHAEL SCOTT XING
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City | FORT MILL
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State | SC
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Zip | 29708-8912
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Country | US
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Telephone | 612-358-7596
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Fax | 651-368-9222
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Provider Business Mailing Address
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Address Line | 7124 MICHAEL SCOTT XING
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City | FORT MILL
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State | SC
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Zip | 29708-8912
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Country | US
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Telephone | 612-358-7596
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Fax | 651-368-9222
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Authorized Official
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Title or Position | OWNER, REGISTERED DIETITIAN
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Name | TARA DEWITT ZAUHAR
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Credential | MS RD LD CSSD
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Telephone | 612-358-7596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State | NULL
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