Individual
MS. COLLEEN TALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MPT, DPT
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
Mailing address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
024930
NY
Other
Enumeration date
07/22/2006
Last updated
07/13/2007
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