Doctor Name: | TARYN CAMILLE STUBBS |
NPI Number: | 1003941212 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 1201100945 |
Business Practice Address: | 17164 Haven Ct King George, VA - 224856164 |
Business Phone Number: | 5406632318 |
Business Fax Number: | |
Mailing Address: | 17164 Haven Ct, KING GEORGE |
State: | VA |
Postal Code: | 224856164 |
Phone Number: | 5406632318 |
Fax Number: | |
NPI Enumeration Date: | 02/21/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1744P3200X |
License Number: | 1201100945 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | Prosthetics Case Management |
Taxonomy Definition: |