Individual
ANTIONE J TOLBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
700 PARK AVE, IRONTON, OH 45638-1502
(740) 532-1613
(740) 879-0599
Mailing address
PO BOX 108, IRONTON, OH 45638-0108
(740) 532-1613
(740) 879-0599
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CDCA.176745
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442694
—
OH
Enumeration date
05/13/2021
Last updated
05/28/2021
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