Most Relevant Information
Provider Data
| NPI Number: | 1003546607 |
| Provider Name: | TARA KNISELY MD, MPH |
| Entity Type: | Individual |
| Taxonomy Code: | 207P00000X |
| Specialty: | Emergency Medicine |
| License Number: | 4351049287 |
Most Important Dates
| Enumeration Date: | 06/15/2022 |
| Last Updated: | 06/15/2022 |
Provider Practice Location
1 GENESYS PKWY
GRAND BLANC
MI
484398065
Practice Location Phone/Fax
| Phone: | 8106065000 |
| Fax: |
Provider Mailing Location
1 GENESYS PKWY
GRAND BLANC
MI
484398065
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |