Healthcare Provider Details

I. General information

NPI: 1275080244
Provider Name (Legal Business Name): TAYLOR PFLUGHAUPT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2016
Last Update Date: 01/11/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 STONEY POINT RD SW
CEDAR RAPIDS IA
52404-4961
US

IV. Provider business mailing address

2424 TOWNE HOUSE DR NE
CEDAR RAPIDS IA
52402-2229
US

V. Phone/Fax

Practice location:
  • Phone: 319-304-6022
  • Fax:
Mailing address:
  • Phone: 319-213-1221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number081935
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: