MEDICARE: ROBERT W TOTH DC

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
1	111N00000X	Chiropractor	7055	GA

General Provider Information

NPI Number	:	1508860172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT W TOTH DC

Provider Business Mailing Address
First Line	:	3767 CHAMBLEE DUNWOODY RD
Second Line	:
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-2062
Country	:	US
Telephone Number	:	770-445-3399
Fax Number	:	770-458-3054

Provider Business Practice Location Address
First Line	:	3767 CHAMBLEE DUNWOODY RD
Second Line	:
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-2062
Country	:	US
Telephone Number	:	770-445-3399
Fax Number	:	770-458-3054

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	07/08/2007

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