MEDICARE: TODD MICHAEL TAYLOR D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0007302	CO

General Provider Information

NPI Number	:	1285006965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD MICHAEL TAYLOR D.C.

Provider Business Mailing Address
First Line	:	1206 PIERCE ST APT B13
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80214-1956
Country	:	US
Telephone Number	:	785-477-6126
Fax Number	:

Provider Business Practice Location Address
First Line	:	1206 PIERCE ST APT B13
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80214-1956
Country	:	US
Telephone Number	:	785-477-6126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2015
Last Update Date	:	10/21/2015

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