Provider Demographics
NPI:1699262436
Name:RIVERS, TAYLOR ANN (LAT, ATC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANN
Last Name:RIVERS
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 TRAVERS ST
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-4515
Mailing Address - Country:US
Mailing Address - Phone:774-319-3080
Mailing Address - Fax:
Practice Address - Street 1:24 TRAVERS ST
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-4515
Practice Address - Country:US
Practice Address - Phone:774-319-3080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer