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General NPI Number Information
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NPI Number | 1063946903
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Entity Type | Individual
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Provider Name | TAYLOR L JUMP DPT
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Gender | Male
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 12/08/2022
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Provider Practice Location Address
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Address Line | 20320 N JOHN WAYNE PKWY STE 120
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City | MARICOPA
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State | AZ
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Zip | 85139-2936
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Country | US
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Telephone | 520-635-2260
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Fax | 520-564-3758
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Provider Business Mailing Address
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Address Line | 790 REMINGTON BLVD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4909
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Country | US
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Telephone | 866-370-8206
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Fax | 517-435-3670
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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 | PT292965
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT60765888
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License Number State | WA
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