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General NPI Number Information
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NPI Number | 1407347388
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Entity Type | Individual
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Provider Name | TAYLOR NICOLE BLACK DPT
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Gender | Female
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Dates
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Enumeration Date | 05/25/2018
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 563 UNIVERSITY BLVD
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City | HARRISONBURG
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State | VA
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Zip | 22801-3752
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Country | US
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Telephone | 540-534-1338
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Fax | 540-301-2778
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Provider Business Mailing Address
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Address Line | 563 UNIVERSITY BLVD
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City | HARRISONBURG
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State | VA
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Zip | 22801-3752
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Country | US
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Telephone | 540-534-1338
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Fax | 540-301-2778
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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 | 2305211955
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License Number State | VA
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