Individual
MS. TONYA RENE PRIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
111 LAKESIDE DR NE, GRAND RAPIDS, MI 49503-3811
(616) 588-1645
Mailing address
2526 RAY AVE, NEW ERA, MI 49446-9641
(231) 301-9518
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502004698
MI
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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