MEDICARE: VICTORIA TAGGART M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133N00000X	Nutritionist

General Provider Information

NPI Number	:	1568969186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA TAGGART M.S.

Provider Business Mailing Address
First Line	:	1698 ODYSSEY CT
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80109-3658
Country	:	US
Telephone Number	:	314-497-2371
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 WILCOX ST
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-2516
Country	:	US
Telephone Number	:	314-497-2371
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2018
Last Update Date	:	04/10/2018

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Directions to “ VICTORIA TAGGART M.S.” Practice Location

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