Organization
JANINE TALTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANINE TALTY D.O. (PHYSICIAN)
(540) 685-2670
Entity
Organization
Contact information
Practice address
2702 BRAMBLETON AVE SW, ROANOKE, VA 24015-4308
(831) 426-7585
(831) 426-6224
Mailing address
2702 BRAMBLETON AVE SW, ROANOKE, VA 24015-4308
(540) 685-2670
(540) 685-2671
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
0102202736
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102202736
LICENSE
VA
Enumeration date
09/25/2012
Last updated
07/16/2019
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