Individual
TAYLOR JOYCE MCKENZIE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
605 W NORTH ST # 9182, PEOTONE, IL 60468-9182
(815) 370-1764
Mailing address
253 N JACKSON AVE, BRADLEY, IL 60915-1827
(815) 370-1764
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004876
IL
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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