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Individual

MS. MATTIE LOR ROSE TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A.T.C

Contact information

Practice address
20696 ALDO CT, CLINTON TOWNSHIP, MI 48038-2400
(586) 907-7087
Mailing address
20696 ALDO CT, CLINTON TOWNSHIP, MI 48038-2400
(586) 907-7087

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
PA

Other

Enumeration date
07/29/2012
Last updated
07/29/2012
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