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NPI Code Detail

MEDICARE: DR. JESSICA NOEL TAYLOR D.C.

MEDICARE: DR. JESSICA NOEL 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
1111N00000XChiropractorCHIR008546GA
2111N00000XChiropractorDC0000002469TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DC0000002469OTHERTNTN LICENSE

General Provider Information

NPI Number : 1710204722
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JESSICA NOEL TAYLOR D.C.
Provider Business Mailing Address
First Line : 1334 MACKEY BRANCH DRIVE
Second Line : SUITE 104
City : CHATTANOOGA
State : TN
Zip : 37421-3471
Country : US
Telephone Number : 423-296-2604
Fax Number : 423-296-2607
Provider Business Practice Location Address
First Line : 1334 MACKEY BRANCH DRIVE
Second Line : SUITE 104
City : CHATTANOOGA
State : TN
Zip : 37421-3471
Country : US
Telephone Number : 423-296-2604
Fax Number : 423-296-2607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2010
Last Update Date : 06/14/2016

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