Provider Demographics
NPI:1477217016
Name:TAYLOR PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:TAYLOR PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:JAYE
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-286-1170
Mailing Address - Street 1:PO BOX 14461
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73113-0461
Mailing Address - Country:US
Mailing Address - Phone:405-286-1170
Mailing Address - Fax:405-286-1145
Practice Address - Street 1:9300 N KELLEY AVE STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73131-2427
Practice Address - Country:US
Practice Address - Phone:405-286-1170
Practice Address - Fax:405-286-1145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1639298102OtherNPI