Individual
MR. MARSHALL AVERY TALLEY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1215 LAKEBLVD APT5, MARION, OH 43302
(740) 751-5655
Mailing address
1215 LAKEBLVD APT5, MARION, OH 43302
(740) 751-5655
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
374061680794
OH
Other
Enumeration date
01/24/2013
Last updated
01/24/2013
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