Individual
JUSTIN TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1470 N BROADWAY ST, SUITE 100, LEBANON, OH 45036-1744
(513) 932-1936
(513) 932-3105
Mailing address
1470 N BROADWAY ST, SUITE 100, LEBANON, OH 45036-1744
(513) 932-1936
(513) 932-3105
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004858RX
OH
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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