Provider Demographics
NPI:1174497754
Name:ZUBKO, TAYLAR ROSE
Entity type:Individual
Prefix:
First Name:TAYLAR
Middle Name:ROSE
Last Name:ZUBKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 S MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-2593
Mailing Address - Country:US
Mailing Address - Phone:919-342-1357
Mailing Address - Fax:
Practice Address - Street 1:1628 S MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-2593
Practice Address - Country:US
Practice Address - Phone:919-342-1357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT42115225100000X
NCP24416225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist