Provider Demographics
NPI:1962671024
Name:TAYLOR, CAROLYN KAY (CPTA)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:KAY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 E 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-4340
Mailing Address - Country:US
Mailing Address - Phone:650-663-1189
Mailing Address - Fax:620-669-8662
Practice Address - Street 1:810 E 30TH AVE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-4340
Practice Address - Country:US
Practice Address - Phone:650-663-1189
Practice Address - Fax:620-669-8662
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00320225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant