Individual
TAYLOR ILLG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
102 N 25TH ST, FORT DODGE, IA 50501-4338
(515) 416-8822
Mailing address
PO BOX 461, NEVADA, IA 50201-0461
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
111809
IA
Other
Enumeration date
06/07/2022
Last updated
06/07/2022
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