Individual
MR. WILLIE DARE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ABOC,NCLEC,MBOC
Contact information
Practice address
723 RIVER PARK VILLAGE BLVD, MOBILE UNIT DISPENSARY, NORTHVILLE, MI 48167-2777
(313) 378-7883
(248) 465-9985
Mailing address
723 RIVER PARK VILLAGE BLVD, MOBILE UNIT DISPENSARY, NORTHVILLE, MI 48167-2777
(313) 378-7883
(248) 465-9985
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
151016
MI
Other
Enumeration date
06/19/2013
Last updated
06/19/2013
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