Provider Demographics
NPI:1427893478
Name:TOLLIVER, CASSIDI NICOLE (DC)
Entity type:Individual
Prefix:
First Name:CASSIDI
Middle Name:NICOLE
Last Name:TOLLIVER
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:CASSIDI
Other - Middle Name:NICOLE
Other - Last Name:DODGSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3024 SANDPIPER PL
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-3060
Mailing Address - Country:US
Mailing Address - Phone:727-686-3100
Mailing Address - Fax:
Practice Address - Street 1:3024 SANDPIPER PL
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-3060
Practice Address - Country:US
Practice Address - Phone:727-686-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH15059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor