Provider Demographics
NPI:1912139502
Name:TAYLOR, SUZANNE M (PT)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:6714 RITCHIE HWY
Mailing Address - Street 2:SUITE I
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-2319
Mailing Address - Country:US
Mailing Address - Phone:410-787-2229
Mailing Address - Fax:410-787-0141
Practice Address - Street 1:6714 RITCHIE HWY
Practice Address - Street 2:SUITE I
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2319
Practice Address - Country:US
Practice Address - Phone:410-787-2229
Practice Address - Fax:410-787-0141
Is Sole Proprietor?:No
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD171772251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic