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Individual

TABITHA TALLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
604 CHOCTAW ST, ALVA, OK 73717-1626
(580) 327-1112
Mailing address
604 CHOCTAW ST, ALVA, OK 73717-1626

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0116504
OK

Other

Enumeration date
07/29/2021
Last updated
07/29/2021
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