Provider Demographics
NPI:1932779246
Name:FOX, TAYLOR M (PT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:M
Last Name:FOX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 PALMYRA RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1593
Mailing Address - Country:US
Mailing Address - Phone:229-312-5802
Mailing Address - Fax:
Practice Address - Street 1:807 S ISABELLA ST
Practice Address - Street 2:
Practice Address - City:SYLVESTER
Practice Address - State:GA
Practice Address - Zip Code:31791-7554
Practice Address - Country:US
Practice Address - Phone:229-776-6961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTO14156225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist