Provider Demographics
NPI:1669458253
Name:TAYLOR, DARRIN MICHAEL (DC)
Entity Type:Individual
Prefix:
First Name:DARRIN
Middle Name:MICHAEL
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 1:1119 WESTWOOD DR STE A
Mailing Address - Street 2:
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-1473
Mailing Address - Country:US
Mailing Address - Phone:419-232-4470
Mailing Address - Fax:419-238-0710
Practice Address - Street 1:1119 WESTWOOD DR STE A
Practice Address - Street 2:
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-1473
Practice Address - Country:US
Practice Address - Phone:419-232-4470
Practice Address - Fax:419-238-0710
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3039111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2527493Medicaid
OHU78207Medicare UPIN
OH2527493Medicaid