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Individual

PEYTON TAYLOR JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1956 SANDY HOOK RD, GOOCHLAND, VA 23063-3107
(804) 556-3607
Mailing address
PO BOX 166, GOOCHLAND, VA 23063-0166
(804) 556-3607
(804) 556-2414

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202005750
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0202005750
BOARD OF PHARMACY LICENSE
VA
Enumeration date
03/09/2021
Last updated
03/09/2021
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