Provider Demographics
NPI:1225592538
Name:BONE, TAREN (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:TAREN
Middle Name:
Last Name:BONE
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 28TH ST W
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25704-2003
Mailing Address - Country:US
Mailing Address - Phone:304-222-1659
Mailing Address - Fax:
Practice Address - Street 1:613 23RD ST STE G30
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2881
Practice Address - Country:US
Practice Address - Phone:606-327-0036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0052932255A2300X
KYAT14502255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer