Provider Demographics
NPI:1861042178
Name:TAYLOR PHYSICAL THERAPY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:TAYLOR PHYSICAL THERAPY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GAYER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:319-352-5644
Mailing Address - Street 1:121 TOWER ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:IA
Mailing Address - Zip Code:50622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:121 TOWER ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:IA
Practice Address - Zip Code:50622
Practice Address - Country:US
Practice Address - Phone:319-346-9783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAYLOR PHYSICAL THERAPY ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty