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General NPI Number Information
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NPI Number | 1770130205
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Entity Type | Individual
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Provider Name | TAYLOR WHARTON
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Gender | Female
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | 1100 NORMAN ESKRIDGE HWY
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City | SEAFORD
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State | DE
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Zip | 19973-1724
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Country | US
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Telephone | 302-629-3575
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Fax |
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Provider Business Mailing Address
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Address Line | 27216 SHIPWRECK DR
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City | SELBYVILLE
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State | DE
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Zip | 19975-4293
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Country | US
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Telephone | 302-858-3754
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A4173
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License Number State | MD
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