Provider Demographics
NPI:1104988674
Name:TAYLOR, BROOKLYN LEIGH (PT DPT)
Entity type:Individual
Prefix:MRS
First Name:BROOKLYN
Middle Name:LEIGH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:BROOKLYN
Other - Middle Name:LEIGH
Other - Last Name:WILROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT DPT
Mailing Address - Street 1:2080 HARRISON ST STE A
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7447
Mailing Address - Country:US
Mailing Address - Phone:870-569-8167
Mailing Address - Fax:870-277-0896
Practice Address - Street 1:2080 HARRISON ST STE A
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501
Practice Address - Country:US
Practice Address - Phone:870-569-8167
Practice Address - Fax:870-277-0896
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2925225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist