Provider Demographics
NPI:1841778677
Name:TAGLIAFERRO, NICHOLAS GENE (DC)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:GENE
Last Name:TAGLIAFERRO
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 1:1301 W LANE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-3514
Mailing Address - Country:US
Mailing Address - Phone:614-486-3950
Mailing Address - Fax:
Practice Address - Street 1:1301 W LANE AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3514
Practice Address - Country:US
Practice Address - Phone:614-486-3950
Practice Address - Fax:614-486-3960
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-04779111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation