Healthcare Provider Details

I. General information

NPI: 1245158344
Provider Name (Legal Business Name): TAYLOR MARIE KNUDSON DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E JOHNSON ST
HOLYOKE CO
80734-1854
US

IV. Provider business mailing address

1001 E JOHNSON ST
HOLYOKE CO
80734-1854
US

V. Phone/Fax

Practice location:
  • Phone: 970-854-2241
  • Fax:
Mailing address:
  • Phone: 970-854-2241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0019963
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: