Healthcare Provider Details

I. General information

NPI: 1912632324
Provider Name (Legal Business Name): LOREN KRZYSKO TAYLOR PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5230 WILLOW CREEK DR STE 101
SPRINGDALE AR
72762-0898
US

IV. Provider business mailing address

14049 WOLF DR
ROGERS AR
72756-7331
US

V. Phone/Fax

Practice location:
  • Phone: 479-445-6800
  • Fax:
Mailing address:
  • Phone: 847-650-4069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number4996
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number4996
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: