MR. Russell Wayne Tolliver
NPI #1972796175 in Jacksonville, Florida
Provider Information
- NPI Number
- 1972796175
- Entity Type
- Individual
- Name
- MR. Russell Wayne Tolliver
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Aug 21, 2007
- Last Updated
- Aug 21, 2007
Practice Location
- Address
- 4083 SUNBEAM RD
- Address 2
- APARTMENT 1409
- City
- Jacksonville
- State
- Florida
- ZIP Code
- 32257-8993
- Phone
- (904) 733-1338
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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