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Individual

JOHNNY ALEX TOLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
562 TWILIGHT BLUE AVE, NORTH LAS VEGAS, NV 89032-8227
(323) 218-1535
Mailing address
562 TWILIGHT BLUE AVE, NORTH LAS VEGAS, NV 89032-8227
(323) 218-1535

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
376K00000X
Nurse's Aide
CNA034060
NV

Other

Enumeration date
08/13/2020
Last updated
08/13/2020
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