Provider Demographics
NPI:1518227487
Name:TAYLOR, BETHANY JOHNSON (MSPT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:JOHNSON
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4306
Mailing Address - Country:US
Mailing Address - Phone:256-582-3020
Mailing Address - Fax:256-582-4009
Practice Address - Street 1:927 FRANKLIN ST SE FL 2
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4305
Practice Address - Country:US
Practice Address - Phone:256-582-3020
Practice Address - Fax:256-582-4009
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3256225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist