Provider Demographics
NPI:1558410746
Name:REYNOLDS-TAYLOR, TONYA (PT, MS)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:REYNOLDS-TAYLOR
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 STATE ROUTE 303
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-5255
Mailing Address - Country:US
Mailing Address - Phone:606-233-7864
Mailing Address - Fax:
Practice Address - Street 1:1290 FAIRCHILD AVE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-1814
Practice Address - Country:US
Practice Address - Phone:330-678-4912
Practice Address - Fax:330-968-4944
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011778225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist