Individual
TAYLOR ADAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1634 S MARION AVE APT B311, SPRINGFIELD, MO 65807-1291
(479) 287-5324
Mailing address
1634 S MARION AVE APT B311, SPRINGFIELD, MO 65807-1291
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2018032224
MO
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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