Provider Demographics
NPI:1073572392
Name:TALLENT, ANN MILLER (DPT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MILLER
Last Name:TALLENT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MILLER
Other - Last Name:GREATHOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 CRESCENT CENTRE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7285
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:502 N MARKET ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-4438
Practice Address - Country:US
Practice Address - Phone:423-664-1070
Practice Address - Fax:423-664-1071
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7369225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist