Provider Demographics
NPI:1205955630
Name:TAYLOR, KERN MORI (DC CCSP)
Entity type:Individual
Prefix:DR
First Name:KERN
Middle Name:MORI
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DC CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 N 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3329
Mailing Address - Country:US
Mailing Address - Phone:406-586-7944
Mailing Address - Fax:
Practice Address - Street 1:24 S WILLSON
Practice Address - Street 2:#9
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715
Practice Address - Country:US
Practice Address - Phone:406-539-0656
Practice Address - Fax:406-586-7944
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT753111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor