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NPI Code Detail

MEDICARE: REBECCA PEYTON TAYLOR WILSON

MEDICARE:   REBECCA PEYTON TAYLOR WILSON
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1255006847
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA PEYTON TAYLOR WILSON
Provider Business Mailing Address
First Line : 401 CHERRY ST APT 3
Second Line :
City : LONDON
State : KY
Zip : 40741-1498
Country : US
Telephone Number : 606-627-2008
Fax Number :
Provider Business Practice Location Address
First Line : 8706 S US HIGHWAY 25
Second Line :
City : CORBIN
State : KY
Zip : 40701-4974
Country : US
Telephone Number : 606-677-1166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2021
Last Update Date : 08/16/2021

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Directions to “ REBECCA PEYTON TAYLOR WILSON ” Practice Location

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