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General NPI Number Information
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NPI Number | 1003771445
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Entity Type | Individual
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Provider Name | TAYLOR SAMUEL QUENZER LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 6377 S REVERE PKWY
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City | CENTENNIAL
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State | CO
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Zip | 80111-6487
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Country | US
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Telephone | 720-378-4214
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Fax |
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Provider Business Mailing Address
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Address Line | 6377 S REVERE PKWY STE 250
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City | CENTENNIAL
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State | CO
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Zip | 80111-6429
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Country | US
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Telephone | 720-663-9331
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 88-4266830
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License Number State | CO
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