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NPI Code Detail

MEDICARE: KAYLA TOENNIS DO

MEDICARE: KAYLA TOENNIS DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207R00000XInternal Medicine PhysicianTL0007844CO

General Provider Information

NPI Number : 1023542412
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA TOENNIS DO
Provider Business Mailing Address
First Line : 400 W 16TH ST
Second Line :
City : PUEBLO
State : CO
Zip : 81003-2781
Country : US
Telephone Number : 719-595-7585
Fax Number : 719-595-7589
Provider Business Practice Location Address
First Line : 400 W 16TH ST
Second Line :
City : PUEBLO
State : CO
Zip : 81003-2781
Country : US
Telephone Number : 719-595-7585
Fax Number : 719-595-7589
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2017
Last Update Date : 06/23/2019

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Directions to “ KAYLA TOENNIS DO” Practice Location

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