Provider Demographics
NPI:1528414687
Name:TAYLOR, CANDICE (DC)
Entity Type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:
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 1:1006 TOP ST STE H
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-7643
Mailing Address - Country:US
Mailing Address - Phone:601-398-1489
Mailing Address - Fax:301-398-0361
Practice Address - Street 1:1006 TOP ST STE H
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7643
Practice Address - Country:US
Practice Address - Phone:601-398-1489
Practice Address - Fax:601-398-0361
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1257111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor