Provider Demographics
NPI:1487670808
Name:RAWDON, TARRA LINN (ATC)
Entity Type:Individual
Prefix:
First Name:TARRA
Middle Name:LINN
Last Name:RAWDON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 BILLY SUNDAY RD
Mailing Address - Street 2:#306
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-8110
Mailing Address - Country:US
Mailing Address - Phone:319-239-5756
Mailing Address - Fax:
Practice Address - Street 1:2622 STANGE RD
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-4065
Practice Address - Country:US
Practice Address - Phone:515-956-4014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA003662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer