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General NPI Number Information
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NPI Number | 1306176904
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Entity Type | Individual
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Provider Name | PATRICIA GAIL TAYLOR LMT
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Gender | Female
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Dates
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Enumeration Date | 01/04/2010
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Last Update Date | 01/04/2010
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Provider Practice Location Address
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Address Line | 348 N FLETCHER AVE HIGHWAY 51 NORTH
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City | MAYO
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State | FL
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Zip | 32066-4502
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Country | US
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Telephone | 386-294-2346
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Fax |
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Provider Business Mailing Address
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Address Line | 1621 SW OPEN SANDS LOOP
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City | GREENVILLE
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State | FL
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Zip | 32331-3615
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Country | US
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Telephone | 850-948-2999
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA39314
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License Number State | FL
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