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1215348719
JACK L. TALLEY
CANTON, GA
NPI
1215348719
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: GA 1489)
Enumeration Date
2014-05-19
Last Update Date
2014-05-19
Business Address
Dr. JACK L. TALLEY Ph.D.
140 E MARIETTA ST
CANTON, GA 30114-3013
Phone number: 770-213-3594
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Mailing Address
Dr. JACK L. TALLEY Ph.D.
140 E MARIETTA ST
CANTON, GA 30114-3013
Phone number: 770-213-3594
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