Provider Demographics
NPI:1598357675
Name:KERRY DEYO TAYLOR WELLNESS, INC
Entity Type:Organization
Organization Name:KERRY DEYO TAYLOR WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE AND BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-538-9888
Mailing Address - Street 1:14 COLUMBIA CIR STE 203
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5163
Mailing Address - Country:US
Mailing Address - Phone:518-512-9626
Mailing Address - Fax:
Practice Address - Street 1:14 COLUMBIA CIR STE 203
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-5163
Practice Address - Country:US
Practice Address - Phone:518-512-9626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty