Provider Demographics
NPI:1750182192
Name:REIS, TAYLOR B (DC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:B
Last Name:REIS
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 S COLONY WAY
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-6929
Mailing Address - Country:US
Mailing Address - Phone:907-745-2575
Mailing Address - Fax:907-745-2576
Practice Address - Street 1:1030 S COLONY WAY
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-6929
Practice Address - Country:US
Practice Address - Phone:907-745-2575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK235486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor