MEDICARE: KENDAYL TAYLOR COKLEY DC

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	2301401300	MI

General Provider Information

NPI Number	:	1730804725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDAYL TAYLOR COKLEY DC

Provider Business Mailing Address
First Line	:	262 UPTOWN DR APT 303
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-5652
Country	:	US
Telephone Number	:	989-200-7473
Fax Number	:

Provider Business Practice Location Address
First Line	:	1570 S EUCLID AVE
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-3318
Country	:	US
Telephone Number	:	989-200-7473
Fax Number	:

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

Provider Enumeration Date	:	10/11/2022
Last Update Date	:	10/11/2022

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Directions to “ KENDAYL TAYLOR COKLEY DC” Practice Location

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