Provider Demographics
NPI:1255459491
Name:TALLEY PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:TALLEY PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:TALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-915-5272
Mailing Address - Street 1:112 GREENVALE DR
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-7896
Mailing Address - Country:US
Mailing Address - Phone:864-915-5272
Mailing Address - Fax:864-859-3111
Practice Address - Street 1:112 GREENVALE DR
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-7896
Practice Address - Country:US
Practice Address - Phone:864-915-5272
Practice Address - Fax:864-859-3111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty