Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Deyonta Tolliver, LAT, ATC

Individual provider Athletic Trainer · NPI 1033619325

Deyonta Tolliver, LAT, ATC is an Athletic Trainer in Saint Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2018.

Licensed in
MO
In the registry since
2018
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

11628 Old Ballas Rd
Saint Louis, MO 63141-7030
Phone: (314) 596-2656
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2017031424 (MO)

Record details

NPI number1033619325
Entity typeIndividual (Type 1)
GenderMale
Credentials LAT , ATC
Sole proprietorNo
NPI enumeratedFebruary 14, 2018
Last updated in NPPESFebruary 14, 2018

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