Healthcare Provider Details

I. General information

NPI: 1770369324
Provider Name (Legal Business Name): MADISON TAYLOR LAGARD ND, DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2023
Last Update Date: 09/22/2024
Certification Date: 09/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 DETROIT AVE
CLEVELAND OH
44113-2733
US

IV. Provider business mailing address

7415 PEARL RD
MIDDLEBURG HEIGHTS OH
44130-6611
US

V. Phone/Fax

Practice location:
  • Phone: 216-353-2800
  • Fax:
Mailing address:
  • Phone: 610-906-9264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-05296
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: