Deyonta Tolliver, LAT, ATC

NPI 1033619325 · on the registry since 2018

Practice

Address: 11628 Old Ballas Rd
Saint Louis, MO 63141
Phone: (314) 596-2656
Organisation at this address: Sgm Homecare Llc
Julianne Reynolds Llc
Nano Consultancy Services Llc
South St. Louis Rehab Institute, Inc.
Saint. Mary'S Complete Home Care, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 12

Registry record

Primary taxonomy: Athletic Trainer
2255A2300X
Licence states on file: MO
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2018-02-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri