Individual
TAYLOR ANN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATS
Contact information
Practice address
1771 US HIGHWAY 117 N, BURGAW, NC 28425-3917
(910) 789-9506
Mailing address
1771 US HIGHWAY 117 N, BURGAW, NC 28425-3917
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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