Individual
MR. JEROME TALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
1135 MONTREAT AVE SW, ATLANTA, GA 30310-3322
(404) 438-7530
Mailing address
1135 MONTREAT AVE SW, ATLANTA, GA 30310-3322
(404) 438-7530
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
126167LGB
GA
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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