Individual
TAYLOR MACKENZIE SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
210 BROOKS ST STE 200, CHARLESTON, WV 25301-1848
(304) 388-1930
Mailing address
111 SUMMIT DR, MOREHEAD, KY 40351-9706
(606) 207-4872
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
2931
WV
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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