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General NPI Number Information
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NPI Number | 1265126122
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Entity Type | Individual
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Provider Name | TAYLOR MARIE VINING DPT
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Gender | Female
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 1711 SW PLAZA PKWY
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City | ANKENY
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State | IA
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Zip | 50023-7013
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Country | US
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Telephone | 515-417-0074
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Fax | 515-224-5140
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Provider Business Mailing Address
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Address Line | 502 NW 10TH ST
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City | ANKENY
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State | IA
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Zip | 50023-4202
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 120409
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License Number State | IA
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