Healthcare Provider Details

I. General information

NPI: 1437706819
Provider Name (Legal Business Name): TAYLOR NOLAN PT, DPT, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2019
Last Update Date: 08/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 E ARLINGTON BLVD
GREENVILLE NC
27858-5868
US

IV. Provider business mailing address

1301 E ARLINGTON BLVD
GREENVILLE NC
27858-5868
US

V. Phone/Fax

Practice location:
  • Phone: 252-565-8812
  • Fax:
Mailing address:
  • Phone: 252-565-8812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: