Individual
TONY HARDAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, NCTMB
Contact information
Practice address
105 W 12TH ST, 105 W. 12TH STREET, CARUTHERSVILLE, MO 63830-1817
(573) 333-1690
Mailing address
105 W 12TH ST, P.O. BOX 727, CARUTHERSVILLE, MO 63830-1817
(573) 333-1690
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2007000188
MO
Other
Enumeration date
06/17/2008
Last updated
06/17/2008
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