| Doctor Name: | MS. TARA M STATEN |
| NPI Number: | 1083781868 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DC |
| License Number: | 2905 |
| Business Practice Address: | 8832 Blakeney Professional Drive Suite 100 Charlotte, NC - 282776735 |
| Business Phone Number: | 7048177618 |
| Business Fax Number: | 7048177887 |
| Mailing Address: | 8832 Blakeney Professional Drive, Suite 100 CHARLOTTE |
| State: | NC |
| Postal Code: | 282776735 |
| Phone Number: | 7048177618 |
| Fax Number: | 7048177887 |
| NPI Enumeration Date: | 11/29/2006 |
| NPI Last Update Date: | 12/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 111N00000X |
| License Number: | 2905 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Chiropractic Providers |
| Taxonomy Classification: | Chiropractor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |