MEDICARE: NATASHA ANGTUOKUU TAYLOR PT, MS OCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	026531-1	NY
2	225100000X	Physical Therapist	P10439	NC
3	2251X0800X	Orthopedic Physical Therapist	5501013500	MI

General Provider Information

NPI Number	:	1033325451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA ANGTUOKUU TAYLOR PT, MS OCS

Provider Business Mailing Address
First Line	:	1051 N CANTON CENTER RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-5097
Country	:	US
Telephone Number	:	716-523-8116
Fax Number	:

Provider Business Practice Location Address
First Line	:	6403 WOODSIDE CT
Second Line	:
City	:	VAN BUREN TOWNSHIP
State	:	MI
Zip	:	48111-5142
Country	:	US
Telephone Number	:	734-644-3293
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	07/24/2024

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