Most Relevant Information
Provider Data
| NPI Number: | 1003363359 |
| Provider Name: | TAYLOR MARIE BANKS |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/03/2016 |
| Last Updated: | 09/03/2016 |
Provider Practice Location
8909 SORRENTO ST
DETROIT
MI
482282671
Practice Location Phone/Fax
| Phone: | 3138287862 |
| Fax: |
Provider Mailing Location
8909 SORRENTO ST
DETROIT
MI
482282671
Provider Mailing Phone/Fax
| Phone: | 3138287862 |
| Fax: |