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1043774219
TARA MADDOX
PHILADELPHIA, PA
NPI
1043774219
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2019-01-22
Last Update Date
2019-01-22
Business Address
TARA MADDOX
8201 HENRY AVE APT K1
PHILADELPHIA, PA 19128-2220
Phone number: 215-696-0888
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Mailing Address
TARA MADDOX
119 MILBOB DR
WARMINSTER, PA 18974-1668
Phone number: 215-696-0888
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