Provider Demographics
NPI:1831349190
Name:TAYLOR, RITA A (LMT)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PLANTATION RD
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29672-7562
Mailing Address - Country:US
Mailing Address - Phone:864-882-6121
Mailing Address - Fax:
Practice Address - Street 1:600 PLANTATION RD
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29672-7562
Practice Address - Country:US
Practice Address - Phone:864-882-6121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3586172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist