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General NPI Number Information
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NPI Number | 1083474399
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Entity Type | Individual
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Provider Name | AMANI MICHELLE TAYLOR DPT
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Gender | Female
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Dates
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Enumeration Date | 03/21/2024
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 83 GRASSO PLZ
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City | SAINT LOUIS
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State | MO
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Zip | 63123-3107
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Country | US
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Telephone | 314-940-7814
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Fax | 314-798-6688
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Provider Business Mailing Address
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Address Line | 83 GRASSO PLZ
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City | SAINT LOUIS
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State | MO
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Zip | 63123-3107
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Country | US
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Telephone | 314-940-7814
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Fax | 314-798-6688
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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 | 070.028853
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License Number State | IL
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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 | 2024006187
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License Number State | MO
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