Individual
DONTAVIOUS TOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
50 MAIN ST, WATER VALLEY, MS 38965
(662) 473-4777
Mailing address
104 COUNTY ROAD 550, WATER VALLEY, MS 38965-3484
(662) 801-2104
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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