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General NPI Number Information
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NPI Number | 1427622505
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Entity Type | Individual
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Provider Name | TAYLOR BUELL ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 05/13/2021
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 4450 CAMP SWIFT RD
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City | FORT DRUM
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State | NY
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Zip | 13602
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Country | US
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Telephone | 315-772-6730
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Fax |
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Provider Business Mailing Address
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Address Line | 9716 STATE ROUTE 812
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City | CROGHAN
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State | NY
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Zip | 13327-2207
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 004675
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License Number State | NY
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