Provider Demographics
NPI:1043394455
Name:TAYLOR, BARRY HOWLAND (DC)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:HOWLAND
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 GARFIELD ST NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-2225
Mailing Address - Country:US
Mailing Address - Phone:763-226-8031
Mailing Address - Fax:612-255-0952
Practice Address - Street 1:3930 NORTHWOODS DR
Practice Address - Street 2:
Practice Address - City:ARDEN HILLS
Practice Address - State:MN
Practice Address - Zip Code:55112-6963
Practice Address - Country:US
Practice Address - Phone:612-255-0952
Practice Address - Fax:612-255-0952
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4564111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN266968400Medicaid
MN350003175Medicare ID - Type Unspecified
MN266968400Medicaid