Provider Demographics
NPI:1134833734
Name:TAYLOR, ALEXANDRIA M (DPT)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:M
Other - Last Name:FURDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-777-6236
Mailing Address - Fax:423-777-6236
Practice Address - Street 1:339 W THIRD ST
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:MS
Practice Address - Zip Code:39074-4107
Practice Address - Country:US
Practice Address - Phone:601-287-8007
Practice Address - Fax:601-287-8038
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
MSPT7466225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist