Healthcare Provider Details

I. General information

NPI: 1750418240
Provider Name (Legal Business Name): JASON CURTIS TAYLOR D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 E WARNER RD SUITE 113
GILBERT AZ
85296-3054
US

IV. Provider business mailing address

690 E WARNER RD STE #113
GILBERT AZ
85296-3054
US

V. Phone/Fax

Practice location:
  • Phone: 480-633-3399
  • Fax: 480-633-5605
Mailing address:
  • Phone: 480-633-3399
  • Fax: 480-633-5605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7539
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: