MEDICARE: MR. THOMAS R 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	0104300	KS

General Provider Information

NPI Number	:	1295057859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS R TAYLOR D.C.

Provider Business Mailing Address
First Line	:	16701 MISSION RD
Second Line	:
City	:	STILWELL
State	:	KS
Zip	:	66085-9109
Country	:	US
Telephone Number	:	913-220-5183
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 E SANTA FE ST
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66061-3457
Country	:	US
Telephone Number	:	913-780-6000
Fax Number	:	913-780-6057

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

Provider Enumeration Date	:	02/24/2010
Last Update Date	:	02/24/2010

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