| NPI | 1114001765 |
|---|---|
| Former Name | TARA M MAHONEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-1824) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2019-05-15 |