Individual
LAUREN ELISABETH TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2620 METAIRIE LAWN DR, METAIRIE, LA 70002-6107
(504) 841-0150
(504) 841-0180
Mailing address
2620 METAIRIE LAWN DR, METAIRIE, LA 70002-6107
(504) 841-0150
(504) 841-0180
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10601
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10601
PROVISIONAL LICENSE
LA
Enumeration date
07/21/2020
Last updated
07/21/2020
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