Provider Demographics
NPI:1831527274
Name:TAYLOR, LESLEY SUZANNE (DC)
Entity type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:SUZANNE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3514 INTERNATIONAL ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-7382
Mailing Address - Country:US
Mailing Address - Phone:907-452-2347
Mailing Address - Fax:888-255-4359
Practice Address - Street 1:3514 INTERNATIONAL ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-7382
Practice Address - Country:US
Practice Address - Phone:907-452-2347
Practice Address - Fax:888-255-4359
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-22
Last Update Date:2016-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK579111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor