Healthcare Provider Details

I. General information

NPI: 1477217016
Provider Name (Legal Business Name): TAYLOR PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2021
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 CEDAR LAKE BLVD STE 120
OKLAHOMA CITY OK
73114-7815
US

IV. Provider business mailing address

PO BOX 14461
OKLAHOMA CITY OK
73113-0461
US

V. Phone/Fax

Practice location:
  • Phone: 405-286-1170
  • Fax: 405-286-1145
Mailing address:
  • Phone: 405-286-1170
  • Fax: 405-286-1145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH TAYLOR
Title or Position: CLINIC DIRECTOR
Credential:
Phone: 405-286-1170