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General NPI Number Information
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NPI Number | 1285908418
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Entity Type | Individual
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Provider Name | LAURA CHRISTINE TALLENT LPTA
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Gender | Female
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Dates
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Enumeration Date | 03/06/2012
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 1204 SHERMAN DR
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City | WHITESBORO
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State | TX
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Zip | 76273
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Country | US
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Telephone | 940-564-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 210 S RAY ROBERTS PKWY
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City | TIOGA
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State | TX
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Zip | 76271-3527
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Country | US
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Telephone | 469-951-0270
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA 23105
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2115823
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License Number State | TX
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