Individual
LORETTA DEE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
210 PROFESSIONAL PARK DR SE STE 10, BLACKSBURG, VA 24060-6649
(540) 605-8751
Mailing address
210 PROFESSIONAL PARK DR SE STE 10, BLACKSBURG, VA 24060-6649
(540) 605-8751
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019017139
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083950406
WORKERS COMPENSATION
—
Enumeration date
12/21/2021
Last updated
12/21/2021
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