Provider Demographics
NPI:1740483007
Name:TAIG FAMILY CHIROPRACTIC PS
Entity type:Organization
Organization Name:TAIG FAMILY CHIROPRACTIC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:TAIG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:1616-949-9282
Mailing Address - Street 1:5510 CASCADE RD SE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-6496
Mailing Address - Country:US
Mailing Address - Phone:616-949-9282
Mailing Address - Fax:616-949-2374
Practice Address - Street 1:5510 CASCADE RD SE
Practice Address - Street 2:SUITE 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950D100330OtherBCBS
MI950D113230OtherBCBS
MI950D100330OtherBCBS
MION86130001Medicare ID - Type Unspecified
MI950D113230OtherBCBS
MION86130001Medicare UPIN