Provider Demographics
NPI:1497404644
Name:STORM, TAYLOR (DC)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:
Last Name:STORM
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 1:338 SIDNEY LN
Mailing Address - Street 2:
Mailing Address - City:WEBB CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64870-9271
Mailing Address - Country:US
Mailing Address - Phone:262-745-0832
Mailing Address - Fax:
Practice Address - Street 1:2318 E 32ND ST STE B
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4326
Practice Address - Country:US
Practice Address - Phone:417-781-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022010602111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor