Individual
THERESE MARIE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
148 N MAIN ST APT 2, ROCKFORD, MI 49341-1016
(616) 581-5949
Mailing address
148 N MAIN ST APT 2, ROCKFORD, MI 49341-1016
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703054103
MI
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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