Provider Demographics
NPI:1659727683
Name:TAYLOR, MATTHEW MILTON (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:MILTON
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 W SUNSET BLVD
Mailing Address - Street 2:SUITE 18
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-6565
Mailing Address - Country:US
Mailing Address - Phone:435-656-0521
Mailing Address - Fax:435-304-3298
Practice Address - Street 1:1812 W SUNSET BLVD
Practice Address - Street 2:SUITE 18
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-6565
Practice Address - Country:US
Practice Address - Phone:435-656-0521
Practice Address - Fax:435-304-3298
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5937633-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor