Provider Demographics
NPI:1770001323
Name:TAYLOR, AMBER LEIGH (DPT, PT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LEIGH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:LEIGH
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, PT
Mailing Address - Street 1:PO BOX 1769
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20118-1769
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24560 SOUTHPOINT DR
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-3504
Practice Address - Country:US
Practice Address - Phone:571-370-3686
Practice Address - Fax:571-370-3687
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305211473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist