MEDICARE: TAYLOR GARLOCK 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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1689356750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR GARLOCK DPT

Provider Business Mailing Address
First Line	:	4349 TALMADGE RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-3527
Country	:	US
Telephone Number	:	419-559-5591
Fax Number	:	866-268-5006

Provider Business Practice Location Address
First Line	:	4349 TALMADGE RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-3527
Country	:	US
Telephone Number	:	419-559-5591
Fax Number	:	866-268-5006

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

Provider Enumeration Date	:	08/07/2023
Last Update Date	:	08/07/2023

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