Provider Demographics
NPI:1912216011
Name:TOLLE, LEVI HARRISON (DC)
Entity Type:Individual
Prefix:
First Name:LEVI
Middle Name:HARRISON
Last Name:TOLLE
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 1:133 ELLIOTT AVE
Mailing Address - Street 2:
Mailing Address - City:PEEBLES
Mailing Address - State:OH
Mailing Address - Zip Code:45660-1027
Mailing Address - Country:US
Mailing Address - Phone:937-587-2613
Mailing Address - Fax:937-587-3911
Practice Address - Street 1:133 ELLIOTT AVE
Practice Address - Street 2:
Practice Address - City:PEEBLES
Practice Address - State:OH
Practice Address - Zip Code:45660
Practice Address - Country:US
Practice Address - Phone:937-587-2613
Practice Address - Fax:937-587-3911
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4115111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor