MEDICARE: MS. CHARLOTTE ANN TAYLOR P.T.

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	1040	NV

General Provider Information

NPI Number	:	1841436839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHARLOTTE ANN TAYLOR P.T.

Provider Business Mailing Address
First Line	:	2835 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5307
Country	:	US
Telephone Number	:	702-951-2243
Fax Number	:	702-951-2262

Provider Business Practice Location Address
First Line	:	2835 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5307
Country	:	US
Telephone Number	:	702-951-2243
Fax Number	:	702-951-2262

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

Provider Enumeration Date	:	12/23/2008
Last Update Date	:	02/05/2018

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