Provider Demographics
NPI:1164443396
Name:TAYLORD SPINES
Entity Type:Organization
Organization Name:TAYLORD SPINES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CADE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-388-9268
Mailing Address - Street 1:129 VILLAGE DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-9618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:129 VILLAGE DR
Practice Address - Street 2:SUITE 104
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-9618
Practice Address - Country:US
Practice Address - Phone:406-388-9268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1097111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT41333OtherBC/BS PROVIDER #