Provider Demographics
NPI:1528457652
Name:TAYLOR, CIARA (LMT)
Entity type:Individual
Prefix:
First Name:CIARA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 MEREDITH RD
Mailing Address - Street 2:
Mailing Address - City:RINEYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40162-9773
Mailing Address - Country:US
Mailing Address - Phone:502-558-9851
Mailing Address - Fax:
Practice Address - Street 1:215 MEREDITH RD
Practice Address - Street 2:
Practice Address - City:RINEYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40162-9773
Practice Address - Country:US
Practice Address - Phone:502-558-9851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYBMTMTH00216441225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist