Provider Demographics
NPI:1558409755
Name:TAYLOR, RITA FAYE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:FAYE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 ATEN RD
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-7713
Mailing Address - Country:US
Mailing Address - Phone:724-695-5098
Mailing Address - Fax:
Practice Address - Street 1:50 THOMS RUN RD
Practice Address - Street 2:ATHLETIC TRAINER
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-2835
Practice Address - Country:US
Practice Address - Phone:412-429-2238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0032352255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer