Provider Demographics
NPI:1467135939
Name:JOHNSON, TAYLOR ELISE (DPT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ELISE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:KY
Mailing Address - Zip Code:42347-0148
Mailing Address - Country:US
Mailing Address - Phone:270-504-1910
Mailing Address - Fax:270-298-3824
Practice Address - Street 1:3500 VILLA PT STE 110
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-7826
Practice Address - Country:US
Practice Address - Phone:270-691-0059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist