Individual
TAYLOR DICOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6857 CONVENT ST, CROGHAN, NY 13327-2802
(315) 286-1655
Mailing address
6857 CONVENT ST, CROGHAN, NY 13327-2802
(315) 286-1655
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
026916
NY
Other
Enumeration date
04/13/2015
Last updated
04/13/2015
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