Provider Demographics
NPI:1285006965
Name:TAYLOR, TODD MICHAEL (DC)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:MICHAEL
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 1:1206 PIERCE ST APT B13
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-1956
Mailing Address - Country:US
Mailing Address - Phone:785-477-6126
Mailing Address - Fax:
Practice Address - Street 1:1206 PIERCE ST APT B13
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-1956
Practice Address - Country:US
Practice Address - Phone:785-477-6126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007302111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor