Individual
JACK D TALLMAN SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
1200 N WEST AVE, SUITE 300, JACKSON, MI 49202-2179
(517) 789-1234
(517) 784-7040
Mailing address
1200 N WEST AVE, SUITE 300, JACKSON, MI 49202-2179
(517) 789-1234
(517) 784-7040
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
807299
MI
Other
Enumeration date
05/10/2010
Last updated
05/10/2010
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