Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | PT013947 | GA |
NPI | 1518595149 |
---|---|
Provider Name | Dr. Taylor Crow Middleton |
First Address | Alpharetta, GA 30005-3000 |
Second Address | Kennesaw, GA 30144-3646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2020 |
Last Update Date | 30/03/2020 |