Individual
TONYA TOURVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
123 UNION ST S, MORA, MN 55051-1542
(218) 380-4110
Mailing address
1404 SERVICE RD, MORA, MN 55051-7701
(218) 380-4110
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-417-9776
FEDERAL TAX ID
MN
Enumeration date
03/13/2018
Last updated
02/15/2019
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