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General NPI Number Information
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NPI Number | 1750598181
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Entity Type | Individual
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Provider Name | CORY LYNN TAYLOR O.T.R.L.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1155 INDIAN SPRINGS RD
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City | INDIANA
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State | PA
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Zip | 15701-3466
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Country | US
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Telephone | 724-464-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 1947 WOPSY RD
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City | DYSART
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State | PA
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Zip | 16636-9005
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Country | US
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Telephone | 814-931-7370
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OC009062
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 05548
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License Number State | MD
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