Provider Demographics
NPI:1528040029
Name:THERESA M TAYLOR
Entity Type:Organization
Organization Name:THERESA M TAYLOR
Other - Org Name:CENTRAL COAST PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LASSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-570-0510
Mailing Address - Street 1:919 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-3912
Mailing Address - Country:US
Mailing Address - Phone:831-754-0833
Mailing Address - Fax:831-754-4358
Practice Address - Street 1:919 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3912
Practice Address - Country:US
Practice Address - Phone:831-754-0833
Practice Address - Fax:831-754-4358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty