Provider Demographics
NPI:1225238744
Name:TAYLOR, JAMES ROBERT IV (PT ATC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ROBERT
Last Name:TAYLOR
Suffix:IV
Gender:M
Credentials:PT ATC
Other - Prefix:
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Mailing Address - Street 1:370 HIGHLAND PARK DR STE 1
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-3546
Mailing Address - Country:US
Mailing Address - Phone:859-625-9700
Mailing Address - Fax:859-625-1555
Practice Address - Street 1:370 HIGHLAND PARK DR STE 1
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-3546
Practice Address - Country:US
Practice Address - Phone:859-625-9700
Practice Address - Fax:859-625-1555
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY005169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist