Individual
TAYLOR BEAVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
11200 GOVERNOR MANLY WAY, RALEIGH, NC 27614-8599
(330) 819-7243
Mailing address
429 FOWLKES ST, WENDELL, NC 27591-7763
(330) 819-7243
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-2837
NC
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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