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General NPI Number Information
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NPI Number | 1942245501
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Entity Type | Individual
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Provider Name | ALISON MARIE TALLEY ATC, MS
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Gender | Female
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 7701 YORK AVE S SUITE 300
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City | EDINA
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State | MN
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Zip | 55435-5238
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Country | US
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Telephone | 952-926-6489
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Fax |
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Provider Business Mailing Address
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Address Line | 1806 PARKER RD
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City | ST LOUIS PARK
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State | MN
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Zip | 55426-1852
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Country | US
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Telephone | 952-393-1243
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | MN
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