Individual
MR. IVAN TOLBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1702 DAKOTA AVE, RICHMOND, VA 23220-6911
(804) 477-7447
Mailing address
PO BOX 3586, NORTH CHESTERFIELD, VA 23235-7586
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
174400000X
Specialist
—
—
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
09/03/2016
Last updated
09/03/2016
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