Provider Demographics
NPI:1447512249
Name:WEGLICKI, JOHN TAYLOR (DPT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:TAYLOR
Last Name:WEGLICKI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 CRESCENT CENTRE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7285
Mailing Address - Country:US
Mailing Address - Phone:615-416-0199
Mailing Address - Fax:615-866-3752
Practice Address - Street 1:2735 LEGENDS PKWY
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066
Practice Address - Country:US
Practice Address - Phone:334-310-2100
Practice Address - Fax:331-310-2203
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH8353225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist