Provider Demographics
NPI:1215518410
Name:TOLMAN, DAFNE D (DC)
Entity type:Individual
Prefix:
First Name:DAFNE
Middle Name:D
Last Name:TOLMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 E WINCHESTER ST STE 130
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5084
Mailing Address - Country:US
Mailing Address - Phone:801-200-5200
Mailing Address - Fax:385-384-2535
Practice Address - Street 1:480 E WINCHESTER ST STE 130
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5084
Practice Address - Country:US
Practice Address - Phone:801-200-5200
Practice Address - Fax:385-384-2535
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11912605-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor