Individual
HEATHER SUE TALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
624 W 300 N, VALPARAISO, IN 46385-9203
(219) 707-6664
Mailing address
624 W 300 N, VALPARAISO, IN 46385-9203
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002150A
IN
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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