MEDICARE: TAYLOR FINNERTY ATC

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	2255A2300X	Athletic Trainer	AT007183	OH

General Provider Information

NPI Number	:	1245914233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR FINNERTY ATC

Provider Business Mailing Address
First Line	:	5300 RIVERSIDE DR UNIT 142
Second Line	:
City	:	UPPER ARLINGTON
State	:	OH
Zip	:	43220-2791
Country	:	US
Telephone Number	:	440-591-4695
Fax Number	:

Provider Business Practice Location Address
First Line	:	5300 RIVERSIDE DR UNIT 142
Second Line	:
City	:	UPPER ARLINGTON
State	:	OH
Zip	:	43220-2791
Country	:	US
Telephone Number	:	440-591-4695
Fax Number	:

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

Provider Enumeration Date	:	06/12/2023
Last Update Date	:	06/04/2025

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