Provider Demographics
NPI:1811938053
Name:TOLAND, CHUCK (MPT)
Entity type:Individual
Prefix:
First Name:CHUCK
Middle Name:
Last Name:TOLAND
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:CHARLES
Other - Middle Name:
Other - Last Name:TOLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:23 E ROBINSON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-4522
Mailing Address - Country:US
Mailing Address - Phone:559-224-2796
Mailing Address - Fax:
Practice Address - Street 1:2615 E CLINTON AVE
Practice Address - Street 2:VA CENTRAL CALIFORNIA HEALTHCARE SYSTEM
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-2223
Practice Address - Country:US
Practice Address - Phone:559-225-6100
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32493225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist