Provider Information for 1932185550
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Mrs. JEANINE TAYLOR
Sex: Female
NPI: 1932185550
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1932185550 | ||||||||
| Enumeration Date | 2005-12-15 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 211 OSCAR DR SUITE A JEFFERSON CITY, MO 65101-5197 United States Phone: 573-635-8299 | Fax:573-635-4629 | ||||||||
| Primary Practice Address | 211 OSCAR DR SUITE A JEFFERSON CITY, MO 65101-5197 United States Phone: 573-635-8299 | Fax:573-635-4629 | ||||||||
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