Individual
JUSTIN C TALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4885 ALPHA RD STE 135, DALLAS, TX 75244-4637
(608) 235-3393
Mailing address
4142 HERSCHEL AVE APT 107, DALLAS, TX 75219-3078
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
1301915
TX
Other
Enumeration date
01/14/2020
Last updated
01/14/2020
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