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Individual

DR. TERESA M TAYLOR

Active
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Individual

DR. TERESA M TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
398T
WY
152W00000X
Optometrist
OPT2576
CO
152W00000X
Optometrist
Primary
TLG35369
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114890700
WY
01
2576
OPT LICENSE
CO
01
35369
TLG LICENSE
CA
05
97871290
CO
Enumeration date
07/28/2005
Last updated
08/08/2023
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