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1437660305
TARA RANDALL
MARIETTA, GA
NPI
1437660305
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: GA F09170149)
Enumeration Date
2017-10-19
Last Update Date
2017-10-19
Business Address
TARA RANDALL
2810 TANNER LAKE TRL NW
MARIETTA, GA 30064-1200
Phone number: 678-516-1053
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Mailing Address
TARA RANDALL
2810 TANNER LAKE TRL NW
MARIETTA, GA 30064-1200
Phone number:
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