Individual
TANYALE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1016 E 156TH PL, DOLTON, IL 60419-2775
(708) 541-0163
Mailing address
1016 E 156TH PL, DOLTON, IL 60419-2775
(708) 541-0163
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
IL
Other
Enumeration date
04/02/2020
Last updated
04/02/2020
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