Provider Demographics
NPI:1518905660
Name:TAIG, CATHERINE DENISE (DC)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:DENISE
Last Name:TAIG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6161 28TH ST SE
Mailing Address - Street 2:STE 16
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-6931
Mailing Address - Country:US
Mailing Address - Phone:616-308-9264
Mailing Address - Fax:
Practice Address - Street 1:5510 CASCADE RD SE
Practice Address - Street 2:STE 280
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-6496
Practice Address - Country:US
Practice Address - Phone:616-949-9282
Practice Address - Fax:616-949-2374
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI2301008542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2301008542OtherMI CHIROPRACTIC LICENSE
MI111N00000XOtherTAXONOMY
MI950D100330OtherBLUE CROSS BLUE SHIELD MI
MIU91892Medicare UPIN