Provider Demographics
NPI:1346219128
Name:TAYLOR, MARY BARKER (DC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:BARKER
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:120 CAPCOM AVENUE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587
Mailing Address - Country:US
Mailing Address - Phone:919-570-9097
Mailing Address - Fax:919-570-9094
Practice Address - Street 1:120 CAPCOM AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-6530
Practice Address - Country:US
Practice Address - Phone:919-570-9097
Practice Address - Fax:919-570-9094
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2011-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC3218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085P7OtherBLUE CROSS BLUE SHIELD