Provider Demographics
NPI:1205422581
Name:HALLER, TAYLOR SUZANNE (DC)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:SUZANNE
Last Name:HALLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:TAYLOR
Other - Middle Name:SUZANNE
Other - Last Name:FORTUNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:7705 E GREENWAY RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1716
Mailing Address - Country:US
Mailing Address - Phone:480-238-5670
Mailing Address - Fax:
Practice Address - Street 1:7705 E GREENWAY RD STE 110
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1716
Practice Address - Country:US
Practice Address - Phone:480-238-5670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8987111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor