Provider Demographics
NPI:1699839068
Name:TALLEY, BRITTNEY COLE (PT)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:COLE
Last Name:TALLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 950248
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0248
Mailing Address - Country:US
Mailing Address - Phone:502-253-4900
Mailing Address - Fax:502-489-5753
Practice Address - Street 1:6580 KENWOOD CROSSING RD
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-7614
Practice Address - Country:US
Practice Address - Phone:502-241-1660
Practice Address - Fax:502-241-1654
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4567225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist