Tara Brooke Centra

Individual provider Active NPI Chiropractor · Reynoldsville, PA

NPI 1194132373 · NPPES record last updated Jan 23, 2015

Key facts

NPI
1194132373
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
DC010900 (PA)
Practice address
105 E Main St
Reynoldsville, PA 15851-1244
Phone
(814) 653-9514
Fax
(814) 653-8842
NPI assigned
Jul 19, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC010900 PA Yes

Addresses

Primary practice location

105 E Main St
Reynoldsville, PA 15851-1244

Mailing address

105 E Main St
Reynoldsville, PA 15851-1244
Phone (814) 653-9514

Other names

  • Tara Brooke Dean Former name

Other providers in Reynoldsville, PA

All providers in Reynoldsville, PA · Chiropractor in Pennsylvania

Sources for this page

Verify at the official NPI Registry.