Provider Demographics
NPI:1518563923
Name:TAIT, JOSEPH WILLIAM II (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:TAIT
Suffix:II
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 1:641 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4913
Mailing Address - Country:US
Mailing Address - Phone:330-821-4455
Mailing Address - Fax:
Practice Address - Street 1:641 E STATE ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4913
Practice Address - Country:US
Practice Address - Phone:330-821-4455
Practice Address - Fax:330-821-4504
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor