Individual
MR. TAYLOR GRANDMAISON GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1253 LANGLEY BLVD, CLAWSON, MI 48017-1026
(248) 733-4315
Mailing address
1253 LANGLEY BLVD, CLAWSON, MI 48017-1026
(248) 733-4315
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501014687
MI
Other
Enumeration date
03/21/2024
Last updated
03/21/2024
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