Provider Demographics
NPI:1316476567
Name:FEATHERLY, TAYLER ANN (DPT)
Entity type:Individual
Prefix:
First Name:TAYLER
Middle Name:ANN
Last Name:FEATHERLY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TAYLER
Other - Middle Name:ANN
Other - Last Name:HOLDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:25 HERITAGE WAY
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3100
Mailing Address - Country:US
Mailing Address - Phone:406-407-7990
Mailing Address - Fax:
Practice Address - Street 1:520 DEWEY AVE
Practice Address - Street 2:STE A
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917
Practice Address - Country:US
Practice Address - Phone:406-297-6778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPTPPTLIC13026225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTPTP-PT-LIC-13026OtherSTATE OF MT PHYSICAL THERAPY LICENSE