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1013979046
ERIC ANTHONY TAYLOR
BOISE, ID
NPI
1013979046
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: ID AT-071)
Enumeration Date
2006-04-05
Last Update Date
2007-07-09
Business Address
Mr. ERIC ANTHONY TAYLOR ATC
12400 W MCMILLAN RD
BOISE, ID 83713-0529
Phone number: 208-340-0753
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Mailing Address
Mr. ERIC ANTHONY TAYLOR ATC
12889 W GOLDENBROOK CT
BOISE, ID 83713-1444
Phone number: 208-350-9626
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