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General NPI Number Information
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NPI Number | 1760883268
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Entity Type | Individual
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Provider Name | TARA WRIGHT DC
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Gender | Female
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 351 N RONALD REAGAN BLVD STE 1015
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City | LONGWOOD
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State | FL
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Zip | 32750-4159
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Country | US
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Telephone | 407-790-7990
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Fax | 607-377-5312
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Provider Business Mailing Address
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Address Line | 351 N RONALD REAGAN BLVD STE 1015
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City | LONGWOOD
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State | FL
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Zip | 32750-4159
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Country | US
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Telephone | 407-790-7990
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Fax | 607-377-5312
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X012696
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH11282
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License Number State | FL
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