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General NPI Number Information
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NPI Number | 1871870766
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Entity Type | Individual
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Provider Name | TAYLOR NEIL MASTEN ATC
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Gender | Male
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Dates
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Enumeration Date | 11/07/2011
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Last Update Date | 11/07/2011
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Provider Practice Location Address
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Address Line | 5150 N MAPLE AVE M/S JA 71
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City | FRESNO
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State | CA
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Zip | 93740-0001
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Country | US
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Telephone | 559-278-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 107 E SIERRA AVE #117
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City | FRESNO
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State | CA
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Zip | 93710-3604
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Country | US
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Telephone | 831-869-9946
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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