Provider Demographics
NPI:1528375490
Name:PECHAUER, TAYLOR ALLEN (DPT)
Entity Type:Individual
Prefix:MR
First Name:TAYLOR
Middle Name:ALLEN
Last Name:PECHAUER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SUAMICO
Mailing Address - State:WI
Mailing Address - Zip Code:54173-8461
Mailing Address - Country:US
Mailing Address - Phone:847-951-9932
Mailing Address - Fax:
Practice Address - Street 1:12315 N VISTOSO PARK RD
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-5819
Practice Address - Country:US
Practice Address - Phone:152-054-4970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1160924225100000X
NCP19947225100000X
MA25769225100000X
AZCP026094T225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist