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Individual

DEMETRIUS TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7803 TEMPLE RD, PHILADELPHIA, PA 19150-2109
(484) 620-0854
Mailing address
7803 TEMPLE RD, PHILADELPHIA, PA 19150-2109
(484) 620-0854

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
57763601
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1039384330001
PA
Enumeration date
12/27/2022
Last updated
12/27/2022
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