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Individual

MR. JAMES RAY TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
845 SOUTH MAIN STREET, SUITE 120, FOND DU LAC, WI 54935
(920) 322-0447
(920) 322-1362
Mailing address
845 SOUTH MAIN STREET, SUITE 120, FOND DU LAC, WI 54935
(920) 322-0447
(920) 322-1362

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5862
WI
225100000X
Physical Therapist
Primary
5862-024
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40308800
WI
Enumeration date
03/16/2007
Last updated
02/01/2010
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