Provider Demographics
NPI:1235940719
Name:TAGUE, TAYLER (DC)
Entity type:Individual
Prefix:DR
First Name:TAYLER
Middle Name:
Last Name:TAGUE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 N MADISON AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-4052
Mailing Address - Country:US
Mailing Address - Phone:317-885-8520
Mailing Address - Fax:
Practice Address - Street 1:622 N MADISON AVE STE 9
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-4052
Practice Address - Country:US
Practice Address - Phone:317-885-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003496A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor