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General NPI Number Information
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NPI Number | 1851895734
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Entity Type | Individual
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Provider Name | ANTHONY TAYLOR LMT, ACMT, SET
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Gender | Male
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 1139 WASHINGTON ST
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City | WHITMAN
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State | MA
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Zip | 02382-1235
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Country | US
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Telephone | 617-431-6543
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Fax |
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Provider Business Mailing Address
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Address Line | 1139 WASHINGTON ST
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City | WHITMAN
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State | MA
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Zip | 02382-1235
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Country | US
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Telephone | 617-431-6543
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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 | 12984
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License Number State | MA
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