Provider Demographics
NPI:1184366445
Name:TAYLOR, AUSTIN CHRISTOPHER (ATS)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:CHRISTOPHER
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8558 LAKE FORREST DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2228
Mailing Address - Country:US
Mailing Address - Phone:770-853-6961
Mailing Address - Fax:
Practice Address - Street 1:520 MARTIN LUTHER KING JR BLVD APT 228
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-3472
Practice Address - Country:US
Practice Address - Phone:770-853-6961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-08
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer