Provider Demographics
NPI:1396223467
Name:KEPPY, TAYLOR (DPT)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:KEPPY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:MERICLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:850 43RD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-8401
Mailing Address - Country:US
Mailing Address - Phone:309-743-2070
Mailing Address - Fax:309-743-2073
Practice Address - Street 1:902 ILLINI DR
Practice Address - Street 2:
Practice Address - City:SILVIS
Practice Address - State:IL
Practice Address - Zip Code:61282-4700
Practice Address - Country:US
Practice Address - Phone:309-796-3450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist