Healthcare Provider Details

I. General information

NPI: 1740104488
Provider Name (Legal Business Name): TAYLOR PEIGHTON SULLIVAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26400 POLLARD RD STE C
DAPHNE AL
36526-4273
US

IV. Provider business mailing address

327 OLD HIGHWAY 431 STE C
OWENS CROSS ROADS AL
35763-9474
US

V. Phone/Fax

Practice location:
  • Phone: 251-270-0880
  • Fax: 251-270-0882
Mailing address:
  • Phone: 256-517-9277
  • Fax: 256-517-9279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH12775
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: