MEDICARE: JEAN TAYLOR MSPT

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	070014000	IL

General Provider Information

NPI Number	:	1861535486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN TAYLOR MSPT

Provider Business Mailing Address
First Line	:	1677 TRENTON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-2044
Country	:	US
Telephone Number	:	913-526-5263
Fax Number	:

Provider Business Practice Location Address
First Line	:	1677 TRENTON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-2044
Country	:	US
Telephone Number	:	913-526-5263
Fax Number	:

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	01/12/2022

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