Provider Demographics
NPI:1356476402
Name:TOTH, JOHN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:THOMAS
Last Name:TOTH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019A WOODLYNN AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1417
Mailing Address - Country:US
Mailing Address - Phone:651-773-9414
Mailing Address - Fax:651-773-8954
Practice Address - Street 1:2019A WOODLYNN AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1417
Practice Address - Country:US
Practice Address - Phone:651-773-9414
Practice Address - Fax:651-773-8954
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4043111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0770OtherHEALTH SERVICE MANAGEMENT
MN080R5VIOtherBLUE CROSS BLUE SHIELD
MN080R5VIOtherBLUE CROSS BLUE SHIELD