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1558910562
ANTWAHN MACK TAYLOR
HENDERSON, NV
NPI
1558910562
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2019-09-11
Last Update Date
2019-09-11
Business Address
ANTWAHN MACK TAYLOR
1644 RAVANUSA DR
HENDERSON, NV 89052-4071
Phone number: 702-672-9117
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Mailing Address
ANTWAHN MACK TAYLOR
1644 RAVANUSA DR
HENDERSON, NV 89052-4071
Phone number: 702-672-9117
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