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1346759586
AUTUMN NICOLE TAYLOR
CHAMPAIGN, IL
NPI
1346759586
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2017-09-20
Last Update Date
2020-10-30
Business Address
AUTUMN NICOLE TAYLOR
1750 S 4TH ST
CHAMPAIGN, IL 61820-6948
Phone number: 443-883-0156
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Mailing Address
AUTUMN NICOLE TAYLOR
719 W HARVARD ST
CHAMPAIGN, IL 61820-2804
Phone number: 443-883-0156
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