Individual
ANTWAHN MACK TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1644 RAVANUSA DR, HENDERSON, NV 89052-4071
(702) 672-9117
Mailing address
1644 RAVANUSA DR, HENDERSON, NV 89052-4071
(702) 672-9117
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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