Provider Demographics
NPI:1225048176
Name:TOURVILLE, SONYA A (DC)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:A
Last Name:TOURVILLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:ANN
Other - Last Name:MARTH-TOURVILLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 406
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:MN
Mailing Address - Zip Code:55363-0406
Mailing Address - Country:US
Mailing Address - Phone:763-675-3121
Mailing Address - Fax:
Practice Address - Street 1:145 NELSON BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:MN
Practice Address - Zip Code:55363
Practice Address - Country:US
Practice Address - Phone:763-675-3121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2892111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN7875640OtherAETNA
MN386328000Medicaid
MN231445OtherCHIROCARE
MN350052039OtherRR MEDICARE
MN0287000044OtherHSM
MN3K701TOOtherBCBS
MN4448016OtherMEDICA