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General NPI Number Information
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NPI Number | 1942504212
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Entity Type | Individual
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Provider Name | JAMES PHILLIP TAYLOR ATC/L
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Gender | Male
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Dates
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Enumeration Date | 12/30/2010
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Last Update Date | 12/30/2010
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Provider Practice Location Address
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Address Line | 380 WOODS COVE RD
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City | SCOTTSBORO
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State | AL
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Zip | 35768-2428
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Country | US
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Telephone | 256-218-3763
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Fax | 256-218-3537
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Provider Business Mailing Address
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Address Line | 288 COUNTY ROAD 589
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City | FORT PAYNE
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State | AL
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Zip | 35968-5752
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Country | US
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Telephone | 256-996-3032
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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 | 444
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License Number State | AL
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