Provider Demographics
NPI:1417700956
Name:TAYLORED 4 YOU HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:TAYLORED 4 YOU HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMMINGS-TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:205-253-3370
Mailing Address - Street 1:6505 WILLOW POND DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-8411
Mailing Address - Country:US
Mailing Address - Phone:205-253-3370
Mailing Address - Fax:
Practice Address - Street 1:10708 BALLANTRAYE DR STE 206
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-4701
Practice Address - Country:US
Practice Address - Phone:540-572-7595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy