Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 9537 | OH |
NPI | 1053347872 |
---|---|
Provider Name | Wiilliam Marcus Taylor |
First Address | Shaker, OH 44122-4100 |
Second Address | Shaker Heights, OH 44122-5260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 01/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2452171 | (05) | OH |