Individual
TAYLOR REGISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
12555 LAKEWOOD BLVD STE D, DOWNEY, CA 90242-2771
(562) 923-4704
(562) 923-6709
Mailing address
12555 LAKEWOOD BLVD STE D, DOWNEY, CA 90242-2771
(562) 923-4704
(562) 923-6709
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA48908
CA
Other
Enumeration date
03/20/2019
Last updated
03/20/2019
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