Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA3508 | MS |
NPI | 1013286210 |
---|---|
Provider Name | Arthur N. Taylor |
First Address | Summit, MS 39666-9132 |
Second Address | Marion, MS 39342-8704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2011 |
Last Update Date | 19/12/2011 |