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1487167169
JONAH THEODORE TAYKOWSKI
EAST LANSING, MI
NPI
1487167169
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36003032A)
Enumeration Date
2017-11-16
Last Update Date
2019-02-14
Business Address
JONAH THEODORE TAYKOWSKI
223 KALAMAZOO ST
EAST LANSING, MI 48824-5400
Phone number: 517-355-1627
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Mailing Address
JONAH THEODORE TAYKOWSKI
338 S WALNUT ST APT B
BLOOMINGTON, IN 47401-3544
Phone number: 517-355-1627
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