Individual
LESLIE TOLLIVER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4100 LAKE OTIS PKWY, SUITE 206, ANCHORAGE, AK 99508-5229
(907) 929-7337
Mailing address
2101 E 74TH AVE # 12C, ANCHORAGE, AK 99507-2776
(907) 351-8401
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
05/20/2016
Last updated
09/15/2016
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