Provider Demographics
NPI:1588836837
Name:TAYLOR CHIROPRACTIC, PLC
Entity Type:Organization
Organization Name:TAYLOR CHIROPRACTIC, PLC
Other - Org Name:OTSEGO FAMILY CHIROPRACTIC WELLNESS CLINIC, PLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADM.
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-694-5871
Mailing Address - Street 1:911 DIX ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:OTSEGO
Mailing Address - State:MI
Mailing Address - Zip Code:49078-1608
Mailing Address - Country:US
Mailing Address - Phone:269-694-5871
Mailing Address - Fax:269-694-5869
Practice Address - Street 1:911 DIX ST
Practice Address - Street 2:SUITE D
Practice Address - City:OTSEGO
Practice Address - State:MI
Practice Address - Zip Code:49078-1608
Practice Address - Country:US
Practice Address - Phone:269-694-5871
Practice Address - Fax:269-694-5869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004704111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty