Provider Demographics
NPI:1023539087
Name:BAXTER, TAYLOR MCKENZIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MCKENZIE
Last Name:BAXTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:MCKENZIE
Other - Last Name:GANTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ATC
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:7721 AIRPORT BLVD STE E120
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-5052
Practice Address - Country:US
Practice Address - Phone:251-631-3680
Practice Address - Fax:251-631-3681
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22112255A2300X
FL20000290442255A2300X
ALPTH10476225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer