Individual
MS. TAYLOR AMELIA LYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
715 CATAWBA CIR, COLUMBIA, SC 29201-5257
(504) 813-4092
Mailing address
715 CATAWBA CIR, COLUMBIA, SC 29201-5257
(504) 813-4092
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1845
SC
Other
Enumeration date
07/17/2015
Last updated
08/24/2015
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