Provider Demographics
NPI:1639955602
Name:TOBAR, JOSELYNE MARJORY (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:JOSELYNE
Middle Name:MARJORY
Last Name:TOBAR
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 HUSSON CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-3723
Mailing Address - Country:US
Mailing Address - Phone:832-794-5544
Mailing Address - Fax:
Practice Address - Street 1:1305 HUSSON CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142-3723
Practice Address - Country:US
Practice Address - Phone:832-794-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV05066832255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer