Provider Demographics
NPI:1619672300
Name:TOULY, ALI
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:TOULY
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 1:12401 W SOLEDAD ST
Mailing Address - Street 2:
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-7243
Mailing Address - Country:US
Mailing Address - Phone:602-561-3948
Mailing Address - Fax:
Practice Address - Street 1:12401 W SOLEDAD ST
Practice Address - Street 2:
Practice Address - City:EL MIRAGE
Practice Address - State:AZ
Practice Address - Zip Code:85335-7243
Practice Address - Country:US
Practice Address - Phone:602-561-3948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)