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1821571704
CHASE EDWARD TAYLOR
FORT WAYNE, IN
NPI
1821571704
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36003070A)
Enumeration Date
2018-09-07
Last Update Date
2018-09-07
Business Address
CHASE EDWARD TAYLOR
2101 E COLISEUM BLVD
FORT WAYNE, IN 46805
Phone number: 260-481-6656
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Mailing Address
CHASE EDWARD TAYLOR
2144 POINT WEST DR APT 2A
FORT WAYNE, IN 46808-4259
Phone number: 785-766-4333
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