Search › Florida › 176B00000X
Tara Dettra, L.M., C.P.M
NPI 1790929438 · on the registry since 2009 · sole proprietor
Practice
- Address
- 1093 A1a Beach Blvd
Pmb 285
Saint Augustine, FL 32080 - Phone
- (904) 540-7994
- Fax
- (904) 471-4980
Registry record
- Primary taxonomy
- 176B00000X
176B00000X
- Licence states on file
- FL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2009-04-24
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida