Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | GA |
NPI | 1003295007 |
---|---|
Provider Name | Taylor Morris Gayle |
First Address | Ooltewah, TN 37363-6511 |
Second Address | Atlanta, GA 30342-1435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2015 |
Last Update Date | 22/05/2015 |