NPI 1164740049

Kyle Taylor, RECOVERYASSISTANT

Practitioner Case Manager/Care Coordinator Melbourne, AR

Practice location

Address: 104 Conniebrook Ln, Melbourne, AR 72556-8861
Phone: (870) 368-5242
Mailing address: PO Box 1589, Benton, AR 72018-1589

Registered specialties

Case Manager/Care Coordinator Primary

Other Service Providers Taxonomy 171M00000X

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Registry record

NPI: 1164740049
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 May 2010
Record last updated: 17 May 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.