Individual
THEDA LORRAINE TALLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
625 W EDWIN ST, WILLIAMSPORT, PA 17701-4909
(570) 326-0565
Mailing address
625 W EDWIN ST, WILLIAMSPORT, PA 17701-4909
(570) 326-0565
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI001718
PA
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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