Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 9658 | TX |
NPI | 1184746596 |
---|---|
Provider Name | Dr. Eric Quentin Taylor |
First Address | Mansfield, TX 76063-0419 |
Second Address | Arlington, TX 76006-4600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2007 |
Last Update Date | 30/08/2007 |