Individual
TONY BURNSIDE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
324 E DEWEY ST STE 104, BUCHANAN, MI 49107-1494
(269) 231-0384
Mailing address
324 E DEWEY ST STE 104, BUCHANAN, MI 49107-1494
(269) 231-0384
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501015684
MI
225700000X
Massage Therapist
MT22408522
IN
Other
Enumeration date
02/25/2025
Last updated
02/25/2025
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