Individual
MARK K TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
110 MAPLE, STOCKBRIDGE, MI 49285
(734) 678-2628
Mailing address
110 MAPLE, STOCKBRIDGE, MI 49285
(734) 678-2628
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
1516
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17
ORTHOTICS/PROSTHETICS
MI
Enumeration date
03/13/2017
Last updated
03/13/2017
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