Provider Demographics
NPI:1831130590
Name:TAYLOR, LARRY D (ATC)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:D
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4054 WATER WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-6407
Mailing Address - Country:US
Mailing Address - Phone:205-824-6250
Mailing Address - Fax:205-824-6251
Practice Address - Street 1:3100 LORNA RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-5453
Practice Address - Country:US
Practice Address - Phone:205-824-6250
Practice Address - Fax:205-824-6251
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer