Provider Demographics
NPI:1225173057
Name:TAYLOR, SADIYQ (DC)
Entity Type:Individual
Prefix:DR
First Name:SADIYQ
Middle Name:
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 1:170 BOULEVARD SE
Mailing Address - Street 2:H125
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-2325
Mailing Address - Country:US
Mailing Address - Phone:404-296-6054
Mailing Address - Fax:404-631-8598
Practice Address - Street 1:1003 HOGANSVILLE RD
Practice Address - Street 2:SUITE G
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30241-1459
Practice Address - Country:US
Practice Address - Phone:404-296-6054
Practice Address - Fax:404-631-8598
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor