Provider Demographics
NPI:1962059717
Name:TOLLIVER, ALICIA (LMBT)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:TOLLIVER
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 E BARBOUR ST
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-1604
Mailing Address - Country:US
Mailing Address - Phone:334-232-4425
Mailing Address - Fax:
Practice Address - Street 1:304 E BARBOUR ST
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-1604
Practice Address - Country:US
Practice Address - Phone:334-232-4425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist