Provider Demographics
NPI:1215549696
Name:URTEL, TAYLOR MICHELLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MICHELLE
Last Name:URTEL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E BETHANY HOME RD UNIT 28
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-1058
Mailing Address - Country:US
Mailing Address - Phone:727-417-1341
Mailing Address - Fax:
Practice Address - Street 1:2175 N ALMA SCHOOL RD STE A106
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2882
Practice Address - Country:US
Practice Address - Phone:480-855-0474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-313872251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics