Provider Demographics
NPI:1811763923
Name:TAYLOR, ALYSE ANN (LMT)
Entity type:Individual
Prefix:
First Name:ALYSE
Middle Name:ANN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ALYSE
Other - Middle Name:ANN
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:1801 W NORTON RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65803-5367
Mailing Address - Country:US
Mailing Address - Phone:417-818-3665
Mailing Address - Fax:
Practice Address - Street 1:1801 W NORTON RD STE 202
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-5367
Practice Address - Country:US
Practice Address - Phone:417-818-3665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist