Provider Demographics
NPI:1285858993
Name:NAYLOR, PATRICIA Y (PT, MS)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:Y
Last Name:NAYLOR
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MS
Mailing Address - Street 1:3535 PIERLAND DR
Mailing Address - Street 2:
Mailing Address - City:POCAHONTAS
Mailing Address - State:IL
Mailing Address - Zip Code:62275-1541
Mailing Address - Country:US
Mailing Address - Phone:618-651-0687
Mailing Address - Fax:618-654-6637
Practice Address - Street 1:650 MARYVILLE UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141
Practice Address - Country:US
Practice Address - Phone:314-529-9309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002023141225100000X
NC5074225100000X
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist