Basic Information
Provider Information
NPI: 1922544006
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAUL
FirstName: TAYLOR
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6397 LEE HWY STE 300
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374212564
CountryCode: US
TelephoneNumber: 4232387217
FaxNumber: 4232383473
Practice Location
Address1: 9760 N ASH AVE
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641579742
CountryCode: US
TelephoneNumber: 8167920803
FaxNumber: 8164079400
Other Information
ProviderEnumerationDate: 01/12/2017
LastUpdateDate: 11/27/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X11-05804KSN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X2017003424MOY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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