Individual
CAROLYN RENNE TOLLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
285 MALLARD COVE ROAD, MONETA, VA 24121
(540) 238-9170
Mailing address
285 MALLARD COVE RD, MONETA, VA 24121-2362
(540) 238-9170
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306601535
VA
Other
Enumeration date
08/13/2009
Last updated
08/13/2009
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