Provider Demographics
NPI:1053584318
Name:THORNE, TONYA (CMT)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:THORNE
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 3RD AVE
Mailing Address - Street 2:APT. B-1
Mailing Address - City:PENTWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49449-9518
Mailing Address - Country:US
Mailing Address - Phone:231-869-9020
Mailing Address - Fax:231-873-3557
Practice Address - Street 1:601 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HART
Practice Address - State:MI
Practice Address - Zip Code:49420-1144
Practice Address - Country:US
Practice Address - Phone:231-873-3577
Practice Address - Fax:231-873-3557
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist