Individual
DAVONTAE LYND TALLEY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
813 HOMEWOOD AVE SE, WARREN, OH 44484-4226
(330) 795-5023
Mailing address
813 HOMEWOOD AVE SE, WARREN, OH 44484-4226
(330) 795-5023
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
07/09/2022
Last updated
03/16/2023
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