Individual
TAYLOR M DATTILO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2065 MATTERN DR, OKLAHOMA CITY, OK 73118-1911
(806) 544-5553
Mailing address
2065 MATTERN DR, OKLAHOMA CITY, OK 73118-1911
(806) 544-5553
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/21/2024
Last updated
02/21/2024
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