Individual
RAEANN TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, ATC, LAT
Contact information
Practice address
4100 S 4TH ST, LEAVENWORTH, KS 66048-5082
(913) 758-4334
Mailing address
120 HOLIDAY TER APT B, LANSING, KS 66043-1230
(816) 826-6024
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
24-00728
KS
Other
Enumeration date
03/05/2014
Last updated
03/05/2014
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