Provider Demographics
NPI:1881278125
Name:TAYLOR, DEBRA LEE (DC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:LEE
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 1:257 TUFTON CT
Mailing Address - Street 2:
Mailing Address - City:CAYCE
Mailing Address - State:SC
Mailing Address - Zip Code:29033-2741
Mailing Address - Country:US
Mailing Address - Phone:304-395-0224
Mailing Address - Fax:
Practice Address - Street 1:430 HERLONG AVE S STE 101
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1094
Practice Address - Country:US
Practice Address - Phone:803-328-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4668111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor