Provider Demographics
NPI:1366030421
Name:TAYLOR, ALEXIS JUSTINA MARIE (DC)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:JUSTINA MARIE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5111 DARROW RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4003
Mailing Address - Country:US
Mailing Address - Phone:330-618-3070
Mailing Address - Fax:
Practice Address - Street 1:5111 DARROW RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4003
Practice Address - Country:US
Practice Address - Phone:330-618-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor