Individual
MICAH JOHN TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
434 MAIN ST, NEW ROCHELLE, NY 10801-6410
(914) 632-5400
Mailing address
48 PURDY AVE APT 2, PORT CHESTER, NY 10573-5053
(914) 215-2425
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
004178-01
NY
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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