Provider Demographics
NPI:1700378890
Name:SPEER, TAYLOR (PT)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:SPEER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:LEDFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:440 MERCHANT DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6470
Mailing Address - Country:US
Mailing Address - Phone:918-270-1378
Mailing Address - Fax:918-270-2398
Practice Address - Street 1:2821 36TH AVE NW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2471
Practice Address - Country:US
Practice Address - Phone:405-310-5224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5461225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist