Provider Demographics
NPI:1447336565
Name:DEBRA H TAYLOR
Entity type:Organization
Organization Name:DEBRA H TAYLOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:251-344-4212
Mailing Address - Street 1:5767-A AIRPORT BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608
Mailing Address - Country:US
Mailing Address - Phone:251-344-4212
Mailing Address - Fax:251-344-4302
Practice Address - Street 1:5767 AIRPORT BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3101
Practice Address - Country:US
Practice Address - Phone:251-344-4212
Practice Address - Fax:251-344-4302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2013-12-13
Deactivation Date:2008-08-04
Deactivation Code:
Reactivation Date:2013-12-13
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty