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1114680808
TARA LORD GROGAN
PHILADELPHIA, PA
NPI
1114680808
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Former Name
TARA PATRICE LORD
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: PA SP024598)
Enumeration Date
2021-10-19
Last Update Date
2021-10-19
Business Address
TARA LORD GROGAN CRNP
3400 CIVIC CENTER BLVD FL 3
PHILADELPHIA, PA 19104-5127
Phone number: 215-316-5151
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Mailing Address
TARA LORD GROGAN CRNP
3400 CIVIC CENTER BLVD FL 3
PHILADELPHIA, PA 19104-5127
Phone number:
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