Individual
MR. MITCHELL ROYCE TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
208 W MCNEESE ST, LAKE CHARLES, LA 70605-5638
(337) 475-1053
(337) 475-1048
Mailing address
1322 ELTON RD, STE I, JENNINGS, LA 70546-4100
(337) 824-4547
(337) 824-4548
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08546
LA
Other
Enumeration date
05/14/2013
Last updated
07/21/2022
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