Individual
TAYLOR MARIE LIFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC, PT, DPT
Contact information
Practice address
63 HOSPITALITY LN STE 3, MINERAL WELLS, WV 26150-6705
(304) 489-8100
(304) 489-8191
Mailing address
1650 LYNDON FARM CT STE 300, LOUISVILLE, KY 40223-5005
(304) 917-3660
(304) 917-3674
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT004688
WV
2255A2300X
Athletic Trainer
AT001684
WV
Other
Enumeration date
10/16/2018
Last updated
11/06/2023
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