Provider Demographics
NPI:1639878366
Name:EASTER, TAYLOR SHIANNE (DC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:SHIANNE
Last Name:EASTER
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 1:127 DESTINY LN
Mailing Address - Street 2:
Mailing Address - City:MANNS CHOICE
Mailing Address - State:PA
Mailing Address - Zip Code:15550-8222
Mailing Address - Country:US
Mailing Address - Phone:814-494-1629
Mailing Address - Fax:
Practice Address - Street 1:127 DESTINY LN
Practice Address - Street 2:
Practice Address - City:MANNS CHOICE
Practice Address - State:PA
Practice Address - Zip Code:15550-8222
Practice Address - Country:US
Practice Address - Phone:814-494-1629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAJ011387111N00000X
PADC011823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor