Provider Demographics
NPI:1972875581
Name:TALBERT, ELYSA MICHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:ELYSA
Middle Name:MICHELLE
Last Name:TALBERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3102
Mailing Address - Country:US
Mailing Address - Phone:407-887-3397
Mailing Address - Fax:
Practice Address - Street 1:165 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3102
Practice Address - Country:US
Practice Address - Phone:407-887-3397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10546111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor