Provider Demographics
NPI:1508332701
Name:TOOZE, KILLIAN ANDREW
Entity Type:Individual
Prefix:
First Name:KILLIAN
Middle Name:ANDREW
Last Name:TOOZE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 FINCASTLE DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-5446
Mailing Address - Country:US
Mailing Address - Phone:703-955-6655
Mailing Address - Fax:
Practice Address - Street 1:6035 FINCASTLE DR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20112-5446
Practice Address - Country:US
Practice Address - Phone:703-955-6655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program