Provider Demographics
NPI:1922136654
Name:TAYLOR, JULIE L (ND, LAC)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 PARK ROW
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2006
Mailing Address - Country:US
Mailing Address - Phone:207-721-1100
Mailing Address - Fax:207-721-0505
Practice Address - Street 1:171 PARK ROW
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2006
Practice Address - Country:US
Practice Address - Phone:207-721-1100
Practice Address - Fax:207-721-0505
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC 143171100000X
MENP 182175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered175F00000XOther Service ProvidersNaturopath