Provider Demographics
NPI:1497011928
Name:TAYLOR CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:TAYLOR CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-793-5050
Mailing Address - Street 1:1149 ROYAL PALM BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1669
Mailing Address - Country:US
Mailing Address - Phone:561-793-5050
Mailing Address - Fax:561-790-6766
Practice Address - Street 1:1149 ROYAL PALM BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1669
Practice Address - Country:US
Practice Address - Phone:561-793-5050
Practice Address - Fax:561-790-6766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-10
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6543111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU59751Medicare UPIN