Provider Demographics
NPI:1376391128
Name:SADOWSKI, TAYLOR JONATHON (DC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JONATHON
Last Name:SADOWSKI
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 1:508 CLIFTON BLUE ST
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-6175
Mailing Address - Country:US
Mailing Address - Phone:919-414-5618
Mailing Address - Fax:
Practice Address - Street 1:616 DR CALVIN JONES HWY STE 104
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-3106
Practice Address - Country:US
Practice Address - Phone:919-761-5158
Practice Address - Fax:919-435-1905
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5765111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty