# JANINE TALTY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831440221
- **Authorized official:** JANINE TALTY D.O. (PHYSICIAN)
- **Authorized official phone:** (540) 685-2670

## Contact information

- **Practice address:** 2702 BRAMBLETON AVE SW, ROANOKE, VA 24015-4308
- **Practice address phone:** (831) 426-7585
- **Practice address fax:** (831) 426-6224
- **Mailing address:** 2702 BRAMBLETON AVE SW, ROANOKE, VA 24015-4308
- **Mailing address phone:** (540) 685-2670
- **Mailing address fax:** (540) 685-2671

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 0102202736 | VA | Yes |

## Other

- **Enumeration date:** 09/25/2012
- **Last updated:** 07/16/2019