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General NPI Number Information
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NPI Number | 1003679358
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Entity Type | Individual
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Provider Name | TAYLOR PURNELL DPT
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Gender | Male
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Dates
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Enumeration Date | 01/31/2024
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 2631 MCINGVALE RD STE 108
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City | HERNANDO
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State | MS
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Zip | 38632-5936
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Country | US
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Telephone | 662-469-9054
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Fax |
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Provider Business Mailing Address
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Address Line | 632 W POPLAR AVE
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City | COLLIERVILLE
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State | TN
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Zip | 38017-2540
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Country | US
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Telephone | 901-850-5246
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Fax | 901-850-5226
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT7691
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License Number State | MS
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