Individual
LATODD TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8825 OAKRIDGE DR, MIDWEST CITY, OK 73110-7417
(480) 284-9170
Mailing address
8825 OAKRIDGE DR, MIDWEST CITY, OK 73110-7417
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
392068921
PRIVATE
OK
Enumeration date
07/18/2012
Last updated
07/18/2012
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