Provider Demographics
NPI:1528376175
Name:FALCON, TANYA ABSHIRE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:ABSHIRE
Last Name:FALCON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 PERRY DR
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-8250
Mailing Address - Country:US
Mailing Address - Phone:337-892-6313
Mailing Address - Fax:337-892-6717
Practice Address - Street 1:308 PERRY DR
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-8250
Practice Address - Country:US
Practice Address - Phone:337-892-6313
Practice Address - Fax:337-892-6717
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA5507-02172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist