Provider Demographics
NPI:1811762123
Name:BABBITT, TAYLOR ALEXIS (DPT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ALEXIS
Last Name:BABBITT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:ALEXIS
Other - Last Name:MORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3108 12TH AVE NW APT 106
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-1625
Mailing Address - Country:US
Mailing Address - Phone:813-731-8426
Mailing Address - Fax:
Practice Address - Street 1:3921 LOCKPORT ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-5541
Practice Address - Country:US
Practice Address - Phone:701-751-3128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-16
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2736225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist