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General NPI Number Information
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NPI Number | 1912430877
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Entity Type | Individual
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Provider Name | BRIANNA ROSE TAYLOR M.S., AT, ATC
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Gender | Female
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 04/07/2017
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Provider Practice Location Address
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Address Line | 15060 HELMER RD S
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City | BATTLE CREEK
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State | MI
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Zip | 49015-9641
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Country | US
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Telephone | 586-741-9724
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Fax |
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Provider Business Mailing Address
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Address Line | 5220 HORIZON DR APT 12
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City | BATTLE CREEK
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State | MI
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Zip | 49015-9671
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Country | US
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Telephone | 586-741-9724
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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 | 2601001502
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License Number State | MI
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