Individual
KATIE TALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
544 E STUART DR STE D, GALAX, VA 24333-2231
(276) 236-5181
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5352
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0110-008925
VA
Other
Enumeration date
10/28/2022
Last updated
12/14/2022
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