Provider Demographics
NPI:1740010586
Name:CROMER, TAYLOR FORD (DPT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:FORD
Last Name:CROMER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 MUTUAL DR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1767
Mailing Address - Country:US
Mailing Address - Phone:864-261-3313
Mailing Address - Fax:864-261-3371
Practice Address - Street 1:120 MUTUAL DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1767
Practice Address - Country:US
Practice Address - Phone:864-261-3313
Practice Address - Fax:864-261-3371
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12483208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty