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NPI Code Detail

MEDICARE: MR. TAYLOR DANIEL BLATTENBERGER DPT

MEDICARE: MR. TAYLOR DANIEL BLATTENBERGER DPT
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
1225100000XPhysical TherapistP21421NC
22251X0800XOrthopedic Physical Therapist2305212337VA

General Provider Information

NPI Number : 1144701954
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TAYLOR DANIEL BLATTENBERGER DPT
Provider Business Mailing Address
First Line : 1749 N STEWART ST STE 50
Second Line :
City : CARSON CITY
State : NV
Zip : 89706-2574
Country : US
Telephone Number : 775-392-3689
Fax Number : 775-783-6191
Provider Business Practice Location Address
First Line : 1749 N STEWART ST STE 50
Second Line :
City : CARSON CITY
State : NV
Zip : 89706-2574
Country : US
Telephone Number : 775-392-3689
Fax Number : 775-783-6191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2018
Last Update Date : 12/28/2023

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