Provider Demographics
NPI:1962431361
Name:TAYLOR, DEBRA (PT)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:TAYLOR
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 1:1261 HILLCREST RD # B1
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-4026
Mailing Address - Country:US
Mailing Address - Phone:251-344-4212
Mailing Address - Fax:251-306-0153
Practice Address - Street 1:1261 HILLCREST RD # B1
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-4026
Practice Address - Country:US
Practice Address - Phone:251-344-4212
Practice Address - Fax:251-306-0153
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH2461225100000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051102171OtherBCBS NEW
AL51543223OtherBCBS DAPHNE LOCATION
AL51528868OtherBCBS
AL51543223OtherBCBS DAPHNE LOCATION