Individual
MRS. TONYA M IMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
433 W HIGH ST, BRYAN, OH 43506-1690
(419) 630-2284
(419) 630-2285
Mailing address
433 W HIGH ST, BRYAN, OH 43506-1690
(419) 630-2284
(419) 630-2285
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.019723
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33.019723
OHIO MEDICAL BOARD
OH
Enumeration date
09/21/2020
Last updated
09/21/2020
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