Individual
TAYLOR BROOKE STOCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3801 MILLER DR, COLUMBIA, MO 65201-5446
(573) 876-5888
(573) 876-5878
Mailing address
3801 MILLER DR, COLUMBIA, MO 65201-5446
(573) 876-5888
(573) 876-5878
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2020002068
—
MO
Enumeration date
10/27/2020
Last updated
10/27/2020
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