Provider Demographics
NPI:1275580540
Name:TAYLOR, COLLEEN E (PT)
Entity Type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:E
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 WASHINGTON ST
Mailing Address - Street 2:ATTN: ADMINISTRATION DEPT
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4500
Mailing Address - Country:US
Mailing Address - Phone:617-734-6135
Mailing Address - Fax:617-734-3744
Practice Address - Street 1:637 WASHINGTON ST
Practice Address - Street 2:ATTN: ADMINISTRATION DEPT
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4500
Practice Address - Country:US
Practice Address - Phone:617-734-6135
Practice Address - Fax:617-734-3744
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007710225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist