Individual
DEVON D TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
455 W MERRICK RD, FREEPORT, NY 11520-4123
(917) 842-6475
Mailing address
455 W MERRICK RD, FREEPORT, NY 11520-4123
(917) 842-6475
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000280-1
NY
Other
Enumeration date
11/13/2011
Last updated
11/13/2011
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