Provider Demographics
NPI:1205508082
Name:THOMPSON, TAYLOR ELIZABETH (DC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ELIZABETH
Last Name:THOMPSON
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 1:352 OLD GALLATIN RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42164-8666
Mailing Address - Country:US
Mailing Address - Phone:270-237-3304
Mailing Address - Fax:
Practice Address - Street 1:352 OLD GALLATIN RD
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42164-8666
Practice Address - Country:US
Practice Address - Phone:270-237-3304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor