Individual
TAD JACOB TAGGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, CD
Contact information
Practice address
1710 LAWRENCE DR STE 200, DE PERE, WI 54115-9195
(920) 570-6339
Mailing address
1657 LENWOOD AVE APT 7, GREEN BAY, WI 54303-5397
(920) 246-4886
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
WI
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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