| NPI | 1770007106 |
|---|---|
| Former Name | TARA MCCLELAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2009017275) |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2017-07-27 |