Individual
JEFFREY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
301 W HOMER ST, MICHIGAN CITY, IN 46360-4358
(219) 879-8511
Mailing address
8259 WICKER AVE, SAINT JOHN, IN 46373-8878
(219) 365-6560
(219) 365-6561
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000843A
IN
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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