Provider Demographics
NPI:1265757215
Name:TALLMAN, LOUISE WATKINS (DC)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:WATKINS
Last Name:TALLMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4380 PEMBERTON CV
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5146
Mailing Address - Country:US
Mailing Address - Phone:770-335-6904
Mailing Address - Fax:
Practice Address - Street 1:4380 PEMBERTON CV
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-5146
Practice Address - Country:US
Practice Address - Phone:770-335-6904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008063111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology