Provider Demographics
NPI:1770738106
Name:TAYLOR'D WELLNESS CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:TAYLOR'D WELLNESS CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CODY
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-377-5977
Mailing Address - Street 1:304 N KENDRICK AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDIVE
Mailing Address - State:MT
Mailing Address - Zip Code:59330-1716
Mailing Address - Country:US
Mailing Address - Phone:406-377-5977
Mailing Address - Fax:
Practice Address - Street 1:304 N KENDRICK AVE
Practice Address - Street 2:
Practice Address - City:GLENDIVE
Practice Address - State:MT
Practice Address - Zip Code:59330-1716
Practice Address - Country:US
Practice Address - Phone:406-377-5977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1186302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization