Individual
MR. WALTER THEODORE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1220 JERRY CLOWER BLVD, YAZOO CITY, MS 39194-3077
(662) 746-9926
(662) 746-9160
Mailing address
1220 JERRY CLOWER BLVD, YAZOO CITY, MS 39194-3077
(662) 746-9926
(662) 746-9160
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-05343
MS
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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