Individual
MRS. MARY ELIZABETH TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
117 7TH AVENUE, SOUTH CHARLESTON, WV 25303
(304) 345-2255
(304) 345-2112
Mailing address
117 7TH AVENUE, SOUTH CHARLESTON, WV 25303
(304) 345-2255
(304) 345-2112
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
347
WV
Other
Enumeration date
12/11/2007
Last updated
12/11/2007
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