Individual
MR. JAK G TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
919 2ND ST NE, CANTON, OH 44704-1132
(330) 454-7917
(330) 454-1476
Mailing address
919 2ND ST NE, CANTON, OH 44704-1132
(330) 454-7917
(330) 454-1476
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0290822
—
OH
Enumeration date
06/10/2009
Last updated
06/10/2009
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