Individual
LARRY TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 PAISANO ST NE, ALBUQUERQUE, NM 87123-1453
(505) 266-0110
Mailing address
30 GIPSON RD, EDGEWOOD, NM 87015-7972
(505) 286-1123
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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