Individual
JEREMY B TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1273 REMOUNT RD, NORTH CHARLESTON, SC 29406-3439
(843) 566-0627
Mailing address
1273 REMOUNT RD, NORTH CHARLESTON, SC 29406-3439
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190166
—
SC
Enumeration date
11/28/2006
Last updated
07/08/2007
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