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NPI Code Detail

MEDICARE: TAYLOR DEXEL

MEDICARE: TAYLOR DEXEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantPTA1779NM

General Provider Information

NPI Number : 1841999323
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR DEXEL
Provider Business Mailing Address
First Line : 3701 MESSINA DR STE 108
Second Line :
City : FARMINGTON
State : NM
Zip : 87402-4780
Country : US
Telephone Number : 505-258-4003
Fax Number :
Provider Business Practice Location Address
First Line : 3701 MESSINA DR STE 108
Second Line :
City : FARMINGTON
State : NM
Zip : 87402-4780
Country : US
Telephone Number : 505-258-4003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2023
Last Update Date : 02/23/2023

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Directions to “ TAYLOR DEXEL ” Practice Location

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