Healthcare Provider Details

I. General information

NPI: 1699690255
Provider Name (Legal Business Name): TAYLOR MEYRICK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E FOX FARM RD UNIT B
CHEYENNE WY
82007-2668
US

IV. Provider business mailing address

1215 E FOX FARM RD UNIT B
CHEYENNE WY
82007-2668
US

V. Phone/Fax

Practice location:
  • Phone: 307-635-2900
  • Fax:
Mailing address:
  • Phone: 307-635-2900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT-2638
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: