| NPI | 1023539087 |
|---|---|
| Other Name | TAYLOR MCKENZIE GANTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH10476) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AL 2211) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL 2000029044) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2021-08-04 |