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General NPI Number Information
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NPI Number | 1003309303
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Entity Type | Individual
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Provider Name | JESSICA Z TAYLOR PTA
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Gender | Female
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 102 IRVING ST NW
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City | WASHINGTON
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State | DC
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Zip | 20010
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Country | US
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Telephone | 202-877-1016
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 LIMESTONE RD
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City | WILMINGTON
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State | DE
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Zip | 19808-5505
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA000178
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A4983
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License Number State | MD
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