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General NPI Number Information
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NPI Number | 1124171608
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Entity Type | Individual
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Provider Name | STEPHEN TAYLOR D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 19110 MONTGOMERY VILLAGE AVE SUITE 200
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City | GAITHERSBURG
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State | MD
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Zip | 20886-3702
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Country | US
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Telephone | 301-548-9079
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Fax |
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Provider Business Mailing Address
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Address Line | 17308 HAVERSTRAW CT
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City | GERMANTOWN
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State | MD
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Zip | 20874-2924
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Country | US
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Telephone | 301-540-6657
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | S01824
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License Number State | MD
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