Provider Demographics
NPI:1659758258
Name:TOLER, TJ
Entity Type:Individual
Prefix:
First Name:TJ
Middle Name:
Last Name:TOLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:J
Other - Last Name:TOLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPTA
Mailing Address - Street 1:261 MORNING STAR DR
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-7830
Mailing Address - Country:US
Mailing Address - Phone:256-479-6951
Mailing Address - Fax:
Practice Address - Street 1:261 MORNING STAR DR
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35811-7830
Practice Address - Country:US
Practice Address - Phone:256-479-6951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-03
Last Update Date:2015-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6878225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant