Healthcare Provider Details

I. General information

NPI: 1730003419
Provider Name (Legal Business Name): LIANA TAYLOR MCMINN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 JASMINE TRL
PRATTVILLE AL
36066-3661
US

IV. Provider business mailing address

605 JASMINE TRL
PRATTVILLE AL
36066-3661
US

V. Phone/Fax

Practice location:
  • Phone: 334-365-2020
  • Fax: 334-365-4845
Mailing address:
  • Phone: 334-365-2020
  • Fax: 334-365-4845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS-F85-TA-E08
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: