Provider Demographics
NPI:1487238614
Name:BOLL, TAYLOR (DO)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:
Last Name:BOLL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:5220 PRESTON CT
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-8656
Mailing Address - Country:US
Mailing Address - Phone:614-301-4535
Mailing Address - Fax:
Practice Address - Street 1:455 SHAWNEE LN
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-4145
Practice Address - Country:US
Practice Address - Phone:740-779-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program