Organization
DERMONE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L TOLLIVER D.O. (PHYSICIAN)
(276) 326-3376
Entity
Organization
Contact information
Practice address
603 BEAMAN ST, CLINTON, NC 28328-2650
(910) 590-1049
Mailing address
725 S COLLEGE AVE, BLUEFIELD, VA 24605-1640
(276) 326-3376
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
07/12/2015
Last updated
07/12/2015
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