Dontavious Toles, PTA

Individual provider Active NPI Physical Therapy Assistant · Water Valley, MS

NPI 1124687207 · NPPES record last updated Jun 11, 2019

Key facts

NPI
1124687207
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
Practice address
50 Main St
Water Valley, MS 38965
Phone
(662) 473-4777
NPI assigned
Jun 11, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X Yes

Addresses

Primary practice location

50 Main St
Water Valley, MS 38965

Mailing address

104 County Road 550
Water Valley, MS 38965-3484
Phone (662) 801-2104

Other providers in Water Valley, MS

All providers in Water Valley, MS · Physical Therapy Assistant in Mississippi

Sources for this page

Verify at the official NPI Registry.