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General NPI Number Information
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NPI Number | 1093368623
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Entity Type | Organization
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Legal Business Name | TAYLORED THERAPIES, PLLC
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Dates
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Enumeration Date | 07/23/2019
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 1004 BEAU TERRE DR STE 507
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City | BENTONVILLE
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State | AR
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Zip | 72712-6799
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Country | US
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Telephone | 479-903-1018
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Fax | 855-738-7702
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Provider Business Mailing Address
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Address Line | 14 WEBBLY LN
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City | BELLA VISTA
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State | AR
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Zip | 72714-2909
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Country | US
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Telephone | 479-903-3488
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Fax | 855-738-7702
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Authorized Official
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Title or Position | OWNER
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Name | MS. HEATHER TAYLOR
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Credential | OTR/L
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Telephone | 479-903-1018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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