Provider Demographics
NPI:1982191946
Name:TONEY, NATHANIEL WILLIS
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:WILLIS
Last Name:TONEY
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 1:5165 SUMMIT RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-9092
Mailing Address - Country:US
Mailing Address - Phone:775-522-4228
Mailing Address - Fax:775-229-4316
Practice Address - Street 1:5165 SUMMIT RIDGE CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-9092
Practice Address - Country:US
Practice Address - Phone:775-522-4228
Practice Address - Fax:775-229-4316
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1428225100000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist