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General NPI Number Information
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NPI Number | 1033881354
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Entity Type | Individual
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Provider Name | WILLIAM ANTHONY TAYLOR DPT
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Gender | Male
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 1214 SALEM ROAD SUITE A
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City | BENTON
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State | AR
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Zip | 72019
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Country | US
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Telephone | 501-915-4354
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1564
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City | BENTON
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State | AR
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Zip | 72018-1564
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Country | US
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Telephone | 501-352-1874
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Fax | 501-457-9090
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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 | 2204
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License Number State | AR
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