Provider Demographics
NPI:1790436962
Name:TARASKI, TAYLOR ANN (DC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANN
Last Name:TARASKI
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 1:5597 HUMMER LAKE RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-2813
Mailing Address - Country:US
Mailing Address - Phone:248-978-4013
Mailing Address - Fax:
Practice Address - Street 1:10990 CHICAGO DR
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-8100
Practice Address - Country:US
Practice Address - Phone:616-546-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor