Individual
TAYLOR MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
964 LOST ANGEL RD, BOULDER, CO 80302-9241
(903) 571-4617
Mailing address
964 LOST ANGEL RD, BOULDER, CO 80302-9241
(903) 571-4617
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Q201038
CO
225700000X
Massage Therapist
Primary
MT.0018679
CO
Other
Enumeration date
01/26/2023
Last updated
01/26/2023
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