Provider Demographics
NPI:1093798688
Name:TOULON, ADAM DAVID (DC, FACFN)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:DAVID
Last Name:TOULON
Suffix:
Gender:M
Credentials:DC, FACFN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3053 GREYFIELD PLACE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067
Mailing Address - Country:US
Mailing Address - Phone:404-932-3302
Mailing Address - Fax:770-792-6113
Practice Address - Street 1:3053 GREYFIELD PLACE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067
Practice Address - Country:US
Practice Address - Phone:404-932-3302
Practice Address - Fax:770-792-6113
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007616111N00000X
FL10019111N00000X, 111NN0400X
CA29781111N00000X, 111NN0400X
GA007616111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111N00000XChiropractic ProvidersChiropractor