Individual
MARK S TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3800 TAYLORVIEW LN, AMMON, ID 83406-8145
(208) 535-0057
Mailing address
3800 TAYLORVIEW LN, AMMON, ID 83406-8145
(208) 535-0057
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1205
ID
Other
Enumeration date
09/11/2006
Last updated
07/08/2007
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