Provider Demographics
NPI:1942504212
Name:TAYLOR, JAMES PHILLIP (ATC/L)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PHILLIP
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 COUNTY ROAD 589
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35968-5752
Mailing Address - Country:US
Mailing Address - Phone:256-996-3032
Mailing Address - Fax:
Practice Address - Street 1:380 WOODS COVE RD
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-2428
Practice Address - Country:US
Practice Address - Phone:256-218-3763
Practice Address - Fax:256-218-3537
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4442255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer