MEDICARE: BACKROADS THERAPY LLC

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	:	1871441527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACKROADS THERAPY LLC

Provider Business Mailing Address
First Line	:	PO BOX 5086
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76708-0086
Country	:	US
Telephone Number	:	254-733-7414
Fax Number	:	254-330-6730

Provider Business Practice Location Address
First Line	:	129 HCR 2226 S
Second Line	:
City	:	AQUILLA
State	:	TX
Zip	:	76622-2467
Country	:	US
Telephone Number	:	254-733-7414
Fax Number	:	254-330-6730

Authorized Official
Title or Position	:	OWNER, SOLE MEMBER
Name	:	TAYLA NICHOLAS TAYLA NICHOLAS
Credential	:	PT
Telephone Number	:	254-733-7414

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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Directions to “BACKROADS THERAPY LLC ” Practice Location

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