Provider Demographics
NPI:1922152354
Name:TAYLOR, KEMMY LOU (DC)
Entity Type:Individual
Prefix:DR
First Name:KEMMY
Middle Name:LOU
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 1:45070 US HWY 41 B
Mailing Address - Street 2:
Mailing Address - City:CHASSELL
Mailing Address - State:MI
Mailing Address - Zip Code:49916
Mailing Address - Country:US
Mailing Address - Phone:906-482-2400
Mailing Address - Fax:906-482-3080
Practice Address - Street 1:45070 US HWY 41 B
Practice Address - Street 2:
Practice Address - City:CHASSELL
Practice Address - State:MI
Practice Address - Zip Code:49916
Practice Address - Country:US
Practice Address - Phone:906-482-2400
Practice Address - Fax:906-482-3080
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008513111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950C150060OtherBCBS
MI950C150060OtherBCBS