Healthcare Provider Details

I. General information

NPI: 1598677411
Provider Name (Legal Business Name): TORIANNA GRACE TODD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 CHESTNUT ST FL 1
SOUTH CHARLESTON WV
25309-1204
US

IV. Provider business mailing address

609 ALBERT ST
CHARLESTON WV
25302-4001
US

V. Phone/Fax

Practice location:
  • Phone: 304-766-8558
  • Fax: 304-766-8561
Mailing address:
  • Phone: 304-993-8475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: