Individual
JACK TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
534 WALLACE RD, AMES, IA 50011-4008
(515) 294-8009
Mailing address
5850 N LUNA AVE, CHICAGO, IL 60646-6524
(773) 633-4466
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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