Provider Demographics
NPI:1174755979
Name:TAGGART, DAMON VIRGIL (DC)
Entity type:Individual
Prefix:DR
First Name:DAMON
Middle Name:VIRGIL
Last Name:TAGGART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 PITTSBURGH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15144-1720
Mailing Address - Country:US
Mailing Address - Phone:724-715-7433
Mailing Address - Fax:724-715-7430
Practice Address - Street 1:911 PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:PA
Practice Address - Zip Code:15144-1720
Practice Address - Country:US
Practice Address - Phone:724-715-7433
Practice Address - Fax:724-715-7430
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010145111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor