| Doctor Name: | TARA GAMBILL |
| NPI Number: | 1083708424 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 006461 |
| Business Practice Address: | 2801 N Decatur Rd Suite 230 Decatur, GA - 300335949 |
| Business Phone Number: | 4042947211 |
| Business Fax Number: | 4042947595 |
| Mailing Address: | 2400 Wisteria Dr, Suite A SNELLVILLE |
| State: | GA |
| Postal Code: | 300782689 |
| Phone Number: | 7709820102 |
| Fax Number: | 7709820130 |
| NPI Enumeration Date: | 10/02/2006 |
| NPI Last Update Date: | 11/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 006461 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |