Provider Demographics
NPI:1295057859
Name:TAYLOR, THOMAS R (DC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:R
Last Name:TAYLOR
Suffix:
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 1:16701 MISSION RD
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:KS
Mailing Address - Zip Code:66085-9109
Mailing Address - Country:US
Mailing Address - Phone:913-220-5183
Mailing Address - Fax:
Practice Address - Street 1:450 E SANTA FE ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-3457
Practice Address - Country:US
Practice Address - Phone:913-780-6000
Practice Address - Fax:913-780-6057
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor