Provider Demographics
NPI:1922660547
Name:HEMMERICK, TAYLOR NOELLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NOELLE
Last Name:HEMMERICK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 HIGHLAND SQUARE DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-2283
Mailing Address - Country:US
Mailing Address - Phone:937-684-0043
Mailing Address - Fax:
Practice Address - Street 1:312 HIGHLAND SQUARE DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-2283
Practice Address - Country:US
Practice Address - Phone:937-684-0043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT014034208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics