Provider Demographics
NPI:1336207695
Name:TAYLOR, MATTHEW J (PT, PHD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:TAYLOR
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Gender:M
Credentials:PT, PHD
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Mailing Address - Street 1:2701 N 16TH STREET
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006
Mailing Address - Country:US
Mailing Address - Phone:620-264-3369
Mailing Address - Fax:602-264-3368
Practice Address - Street 1:10213 N 92ND STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258
Practice Address - Country:US
Practice Address - Phone:480-699-4867
Practice Address - Fax:480-699-4894
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ6075225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZQ05764Medicare UPIN
AZZ77610Medicare ID - Type Unspecified