Provider Demographics
NPI:1245316264
Name:TAYLOR, JOHN FRANKLIN III (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANKLIN
Last Name:TAYLOR
Suffix:III
Gender:M
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:PO BOX 1390
Mailing Address - Street 2:484 MAIN STREET SUITE 14
Mailing Address - City:DIAMOND SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95619-1390
Mailing Address - Country:US
Mailing Address - Phone:530-622-1234
Mailing Address - Fax:530-622-4246
Practice Address - Street 1:484 MAIN ST
Practice Address - Street 2:SUITE 14
Practice Address - City:DIAMOND SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95619-9100
Practice Address - Country:US
Practice Address - Phone:530-622-1234
Practice Address - Fax:530-622-4246
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor