Provider Demographics
NPI:1942245501
Name:TALLEY, ALISON MARIE (ATC, MS)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:MARIE
Last Name:TALLEY
Suffix:
Gender:F
Credentials:ATC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 PARKER RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1852
Mailing Address - Country:US
Mailing Address - Phone:952-393-1243
Mailing Address - Fax:
Practice Address - Street 1:7701 YORK AVE S
Practice Address - Street 2:SUITE 300
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5238
Practice Address - Country:US
Practice Address - Phone:952-926-6489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer