Provider Demographics
NPI:1215756077
Name:CARESTIA, TAYLOR MEGANNE (DPT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MEGANNE
Last Name:CARESTIA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:MEGANNE
Other - Last Name:WIRTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:12 NEWBURYPORT RD
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-1556
Mailing Address - Country:US
Mailing Address - Phone:920-470-9480
Mailing Address - Fax:
Practice Address - Street 1:12 NEWBURYPORT RD
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-1556
Practice Address - Country:US
Practice Address - Phone:920-470-9480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist