Healthcare Provider Details

I. General information

NPI: 1093956757
Provider Name (Legal Business Name): ANNETTE REDDEN TALKERS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNETTE MARIE REDDEN PT

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 03/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 FARRELL DR
COVINGTON KY
41011-3785
US

IV. Provider business mailing address

2222 SULLIVAN TRL
EASTON PA
18040-7958
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-0777
  • Fax: 859-341-1381
Mailing address:
  • Phone: 800-944-9782
  • Fax: 610-438-2024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT001688
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: