Individual
MARILYN TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TRANSPORTATION
Taxonomy
Speciality
Code
Description
License number
State
171WV0202X
Vehicle Modifications Contractor
Primary
065978717
TN
172A00000X
Driver
065978717
TN
Other
Enumeration date
10/31/2016
Last updated
10/31/2016
Update your record
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