Provider Demographics
NPI:1669897815
Name:TOLER, DIANA E (DC)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:E
Last Name:TOLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DIANA
Other - Middle Name:E
Other - Last Name:TOLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:2190 TENBROOK RD
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-1515
Mailing Address - Country:US
Mailing Address - Phone:636-282-8333
Mailing Address - Fax:314-328-5659
Practice Address - Street 1:2190 TENBROOK RD
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010
Practice Address - Country:US
Practice Address - Phone:636-282-8333
Practice Address - Fax:314-328-5659
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-25
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014001824111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor