Individual
MR. LARRY LEE TAYLOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1805 TIFT AVE N STE D, TIFTON, GA 31794-3579
(555) 422-9382
Mailing address
737 DONNA AVE, ASHBURN, GA 31714-3445
(229) 457-9598
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN214375
GA
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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