Provider Demographics
NPI:1912762501
Name:TOLER, CARLEY
Entity type:Individual
Prefix:
First Name:CARLEY
Middle Name:
Last Name:TOLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 DOUBLE CAMP BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:MATEWAN
Mailing Address - State:WV
Mailing Address - Zip Code:25678
Mailing Address - Country:US
Mailing Address - Phone:681-823-0825
Mailing Address - Fax:
Practice Address - Street 1:1625 DOUBLE CAMP BRANCH RD
Practice Address - Street 2:
Practice Address - City:MATEWAN
Practice Address - State:WV
Practice Address - Zip Code:25678
Practice Address - Country:US
Practice Address - Phone:681-823-0825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker