Provider Demographics
NPI:1598793457
Name:TAYLOR, KRISTINE LYNN (DC)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:LYNN
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 1:501 MAIN ST STE 310
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-6049
Mailing Address - Country:US
Mailing Address - Phone:541-887-8170
Mailing Address - Fax:541-887-8180
Practice Address - Street 1:501 MAIN ST STE 310
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-6049
Practice Address - Country:US
Practice Address - Phone:541-887-8170
Practice Address - Fax:541-887-8180
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273056111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR116696Medicare PIN