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1124579008
TAYLOR BEAVERS
RALEIGH, NC
NPI
1124579008
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NC LAT-2837)
Enumeration Date
2016-10-17
Last Update Date
2016-10-17
Business Address
-- TAYLOR BEAVERS LAT, ATC
11200 GOVERNOR MANLY WAY
RALEIGH, NC 27614-8599
Phone number: 330-819-7243
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Mailing Address
-- TAYLOR BEAVERS LAT, ATC
429 FOWLKES ST
WENDELL, NC 27591-7763
Phone number: 330-819-7243
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