Provider Demographics
NPI:1801512611
Name:RINER, TAYLOR DANIEL
Entity type:Individual
Prefix:MR
First Name:TAYLOR
Middle Name:DANIEL
Last Name:RINER
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 1:663 DAHLIA AVE
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-7525
Mailing Address - Country:US
Mailing Address - Phone:909-306-6754
Mailing Address - Fax:
Practice Address - Street 1:663 DAHLIA AVE
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-7525
Practice Address - Country:US
Practice Address - Phone:909-306-6754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians