Provider Demographics
NPI:1871359109
Name:ABDO, TONI (PERSONAL TRAINER)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:ABDO
Suffix:
Gender:M
Credentials:PERSONAL TRAINER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3114 E DIAMOND AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-3916
Mailing Address - Country:US
Mailing Address - Phone:602-412-8401
Mailing Address - Fax:
Practice Address - Street 1:3114 E DIAMOND AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-3916
Practice Address - Country:US
Practice Address - Phone:602-412-8401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist