Provider Demographics
NPI:1083811723
Name:TOLBERT, RIANE M (ATC)
Entity Type:Individual
Prefix:MISS
First Name:RIANE
Middle Name:M
Last Name:TOLBERT
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 NICOLA LN
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-9191
Mailing Address - Country:US
Mailing Address - Phone:302-250-2469
Mailing Address - Fax:
Practice Address - Street 1:2804 AUDUBON VILLAGE DR
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-2262
Practice Address - Country:US
Practice Address - Phone:610-676-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0041362255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer