Provider Demographics
NPI:1649282633
Name:TAYLOR, DANNY RAY (DC)
Entity type:Individual
Prefix:DR
First Name:DANNY
Middle Name:RAY
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 1:2490 E DAVISBURG RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-8547
Mailing Address - Country:US
Mailing Address - Phone:248-660-6504
Mailing Address - Fax:
Practice Address - Street 1:4266 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-4028
Practice Address - Country:US
Practice Address - Phone:989-792-6702
Practice Address - Fax:989-792-1128
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDT004121111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP86969OtherBLUE CARE NETWORK
MIT33376OtherHAP
MIOF35133OtherBLUE CROSS BLUE SHIELD
T33376Medicare UPIN
MIOF35133Medicare ID - Type UnspecifiedMEDICARE