Individual
CORY VON TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.COUN
Contact information
Practice address
1740 E 17TH ST STE C, IDAHO FALLS, ID 83404-6375
(208) 524-1278
Mailing address
1740 EAST 17TH STREET, SUITE C, IDAHO FALLS, ID 83404
(208) 524-1278
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/26/2009
Last updated
07/01/2009
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