Provider Demographics
NPI:1356792253
Name:COX, TAYLOR GARDNER (DC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:GARDNER
Last Name:COX
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 1:2115 S 56TH ST
Mailing Address - Street 2:STE 101
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-6900
Mailing Address - Country:US
Mailing Address - Phone:253-212-0907
Mailing Address - Fax:253-267-1405
Practice Address - Street 1:2115 S 56TH ST
Practice Address - Street 2:STE 101
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-6900
Practice Address - Country:US
Practice Address - Phone:360-693-7781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60619006111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor