Provider Demographics
NPI:1992496897
Name:TAYLOR, BRANDON (DPT)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 179
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-0179
Mailing Address - Country:US
Mailing Address - Phone:443-424-0001
Mailing Address - Fax:443-424-0134
Practice Address - Street 1:1606 DOOLEY RD STE 3
Practice Address - Street 2:
Practice Address - City:WHITEFORD
Practice Address - State:MD
Practice Address - Zip Code:21160-1130
Practice Address - Country:US
Practice Address - Phone:443-424-0001
Practice Address - Fax:443-424-0134
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist