Dr Matthew Lerandal Talley, DC | |
1305 Cedarcrest Road Suite#111, Dallas, GA 30132 | |
(770) 966-5014 | |
Not Available |
Full Name | Dr Matthew Lerandal Talley |
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Gender | Male |
Speciality | Chiropractor |
Location | 1305 Cedarcrest Road Suite#111, Dallas, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255613410 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 2343 (Alabama) | Secondary |
111N00000X | Chiropractor | CHIR009342 (Georgia) | Primary |
Provider Name | Triangle Health Center Pllc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1972258754 PECOS PAC ID: 6901292150 Enrollment ID: O20220415000513 |
Mailing Address | Practice Location Address |
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Dr Matthew Lerandal Talley, DC 1305 Cedarcrest Road Suite#111, Dallas, GA 30132 Ph: (770) 966-5014 | Dr Matthew Lerandal Talley, DC 1305 Cedarcrest Road Suite#111, Dallas, GA 30132 Ph: (770) 966-5014 |
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