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General NPI Number Information
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NPI Number | 1912017666
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Entity Type | Individual
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Provider Name | JENNIFER J TAYLOR MPT, ATC
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 01/10/2014
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Provider Practice Location Address
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Address Line | 3301 W BROADWAY BUSINESS PARK CT STE F
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City | COLUMBIA
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State | MO
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Zip | 65203-0106
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Country | US
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Telephone | 573-447-0422
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Fax | 573-447-0434
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Provider Business Mailing Address
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Address Line | 3301 W BROADWAY BUSINESS PARK CT STE F
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City | COLUMBIA
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State | MO
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Zip | 65203-0106
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Country | US
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Telephone | 573-447-0422
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Fax | 573-447-0434
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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 |
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License Number State |
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