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General NPI Number Information
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NPI Number | 1629379516
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Entity Type | Organization
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Legal Business Name | TYLER T TAYLOR CHIROPRACTIC INC
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Dates
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Enumeration Date | 11/08/2010
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 445 ROSEWOOD AVE SUITE A
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City | CAMARILLO
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State | CA
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Zip | 93010-5929
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Country | US
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Telephone | 805-484-8930
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Fax | 805-987-5323
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Provider Business Mailing Address
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Address Line | 445 ROSEWOOD AVE SUITE A
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City | CAMARILLO
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State | CA
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Zip | 93010-5929
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Country | US
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Telephone | 805-484-8930
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Fax | 805-987-5323
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. TYLER THOMAS TAYLOR
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Credential | D.C.
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Telephone | 805-484-8930
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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 | 29731
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License Number State | CA
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