Provider Demographics
NPI:1588213300
Name:TAYLOR, MS,PT,NHA, SUSAN KATHLEEN
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:KATHLEEN
Last Name:TAYLOR, MS,PT,NHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9667 W OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-4063
Mailing Address - Country:US
Mailing Address - Phone:720-841-3557
Mailing Address - Fax:
Practice Address - Street 1:895 S MONACO PKWY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1501
Practice Address - Country:US
Practice Address - Phone:303-321-3110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6378225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist