Healthcare Provider Details

I. General information

NPI: 1104968064
Provider Name (Legal Business Name): TOIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 W 32ND ST SUITE 106
JOPLIN MO
64804-1529
US

IV. Provider business mailing address

1905 W 32ND ST SUITE 106
JOPLIN MO
64804-1529
US

V. Phone/Fax

Practice location:
  • Phone: 417-626-0072
  • Fax: 417-626-0919
Mailing address:
  • Phone: 417-626-0072
  • Fax: 417-626-0919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD JOSEPH JR.
Title or Position: CEO
Credential:
Phone: 417-626-0072