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Individual

DR. DANIEL P TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O. D.

Contact information

Practice address
431 W COLISEUM BLVD, FORT WAYNE, IN 46805
(260) 484-8516
(260) 484-8521
Mailing address
431 W COLISEUM BLVD, FORT WAYNE, IN 46805-1010
(260) 484-8516
(260) 484-8521

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002712A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200125690
IN
Enumeration date
03/25/2006
Last updated
08/15/2018
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