Provider Demographics
NPI:1558616854
Name:TAYLOR, DANA ANN (PT DPT)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:ANN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:ANN
Other - Last Name:TALAGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3491 S HURON RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-1547
Mailing Address - Country:US
Mailing Address - Phone:989-667-6469
Mailing Address - Fax:
Practice Address - Street 1:3491 S HURON RD
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-1547
Practice Address - Country:US
Practice Address - Phone:989-667-6469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004420225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist