Individual
BRENT TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(765) 423-4000
Mailing address
2335 CARMEL DR, WEST LAFAYETTE, IN 47906-1903
(765) 427-1538
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31001275A
IN
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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