Basic Information
| Provider Information | |||||||||
| NPI: | 1871860767 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SAYLOR PHYSICAL THERAPY | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | SAYLOR PT | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 136 CORPORATE PARK DR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | MOORESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281176959 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043602796 | ||||||||
| FaxNumber: | 7043602798 | ||||||||
| Practice Location | |||||||||
| Address1: | 136 CORPORATE PARK DR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | MOORESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281176959 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043602796 | ||||||||
| FaxNumber: | 7043602798 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2011 | ||||||||
| LastUpdateDate: | 06/20/2018 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SAYLOR | ||||||||
| AuthorizedOfficialFirstName: | JAMII | ||||||||
| AuthorizedOfficialMiddleName: | EDWARD | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7043602796 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | PT AIDE | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 302F00000X | N | Managed Care Organizations | Exclusive Provider Organization | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.