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NPI Code Detail

MEDICARE: KYNIA LYNN TAYLOR PTA

MEDICARE: KYNIA LYNN TAYLOR PTA
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
1225200000XPhysical Therapy AssistantJ2-0000419DE

General Provider Information

NPI Number : 1467585497
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYNIA LYNN TAYLOR PTA
Provider Business Mailing Address
First Line : 4903 WHITE DOVE LN
Second Line :
City : SEAFORD
State : DE
Zip : 19973-6791
Country : US
Telephone Number : 302-628-1599
Fax Number :
Provider Business Practice Location Address
First Line : 1001 MIDDLEFORD RD
Second Line :
City : SEAFORD
State : DE
Zip : 19973-3638
Country : US
Telephone Number : 302-628-5608
Fax Number : 302-628-5651
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 07/08/2007

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Directions to “ KYNIA LYNN TAYLOR PTA” Practice Location

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