Provider Demographics
NPI:1790168821
Name:TAYLOR, JOSHUA ALAN
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ALAN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 CHICAGO DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-1727
Mailing Address - Country:US
Mailing Address - Phone:734-961-5491
Mailing Address - Fax:
Practice Address - Street 1:649 CHICAGO DR
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1727
Practice Address - Country:US
Practice Address - Phone:734-961-5491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other