Individual
MR. JUSTIN BLAKE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
914 INDUSTRIAL PARK RD, DANDRIDGE, TN 37725-4700
(865) 397-3333
Mailing address
208 GREENE LN, TALBOTT, TN 37877-1703
(423) 736-2588
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5161
TN
Other
Enumeration date
02/18/2022
Last updated
02/18/2022
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