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Gladesia Lenea Tolbert
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NPI Number Detailed Information
Provider Information:
Name: | Gladesia Lenea Tolbert |
Gender: | F |
Provider License Number If Given: | 2000160165 |
NPI Information:
NPI: | 1699769109 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 9/12/2005 |
Last Update Date: | 9/18/2014 |
Provider Business Mailing Address:
Address: | 2401 GILLHAM RD Kansas City, MO 64108 |
Phone Number: | 8166828894 |
Fax Number: |
Provider Business Practice Location Address:
Address: | 2401 GILLHAM RD Kansas City, MO 64108 |
Phone Number: | 8162343000 |
Fax Number: |
Provider Taxonomy:
Primary: | 363LP0200X |
Secondary (if any): | |
State: | MO |