Provider Demographics
NPI:1386122463
Name:PERKINS, TAYLOR (DPT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:ELLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1630 MILITARY CUTOFF RD STE 110
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-5719
Mailing Address - Country:US
Mailing Address - Phone:910-798-2318
Mailing Address - Fax:
Practice Address - Street 1:100 SHELL DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337-5174
Practice Address - Country:US
Practice Address - Phone:910-876-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP18224225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist