Provider Demographics
NPI:1861104911
Name:TOLZMAN, KEVIN CHARLES (DPT)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:CHARLES
Last Name:TOLZMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NC
Mailing Address - Zip Code:27371-2802
Mailing Address - Country:US
Mailing Address - Phone:910-571-5000
Mailing Address - Fax:
Practice Address - Street 1:520 ALLEN ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NC
Practice Address - Zip Code:27371-2802
Practice Address - Country:US
Practice Address - Phone:910-571-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT296556225100000X
GAPT013376225100000X
WI14237225100000X
AK142312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist