Provider Demographics
NPI:1598371205
Name:BOHNE, TAYLOR PHILLIP (PT, DPT, ATC, LAT)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:PHILLIP
Last Name:BOHNE
Suffix:
Gender:M
Credentials:PT, DPT, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3336 E CHANDLER HEIGHTS RD STE 126
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-4264
Mailing Address - Country:US
Mailing Address - Phone:480-840-6125
Mailing Address - Fax:
Practice Address - Street 1:3336 E CHANDLER HEIGHTS RD STE 126
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85298-4264
Practice Address - Country:US
Practice Address - Phone:480-840-6125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-31343225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist