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General NPI Number Information
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NPI Number | 1558694109
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Entity Type | Organization
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Legal Business Name | TARA CARRINGTON MS, OTR/L LLC
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Dates
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Enumeration Date | 09/15/2009
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Last Update Date | 09/15/2009
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Provider Practice Location Address
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Address Line | 6150 STATE ROAD 70 E SUITE 5
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City | BRADENTON
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State | FL
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Zip | 34203-9707
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Country | US
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Telephone | 941-224-5859
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Fax |
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Provider Business Mailing Address
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Address Line | 6150 STATE ROAD 70 E SUITE 5
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City | BRADENTON
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State | FL
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Zip | 34203-9707
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Country | US
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Telephone | 941-224-5859
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TARA CARRINGTON
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Credential | MS, OTR/L
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Telephone | 941-224-5859
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | OT12881
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License Number State | FL
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