| NPI | 1528617487 |
|---|---|
| Former Name | TONYA LYNN THREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: WI 13859-146) |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2019-09-04 |