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Individual

BRIAN DAVID TALLERICO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
986 WELLNESS WAY STE 300, FORT MILL, SC 29715-7353
(803) 930-9401
(803) 462-4847
Mailing address
17 LANSING ST, AUBURN, NY 13021-1983
(315) 567-0455
(315) 253-1795

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
036144262
IL
207X00000X
Orthopaedic Surgery Physician
295000
NY
207X00000X
Orthopaedic Surgery Physician
7324A
WY
207X00000X
Orthopaedic Surgery Physician
Primary
89674
SC

Other

Enumeration date
03/14/2006
Last updated
01/03/2025
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