Provider Demographics
NPI:1265685283
Name:SHARP, TONYA D (LMT)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:D
Last Name:SHARP
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4873 STATE ROUTE 5
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-9708
Mailing Address - Country:US
Mailing Address - Phone:330-766-1880
Mailing Address - Fax:330-637-3320
Practice Address - Street 1:1715 WOODLAND ST NE STE 8
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-5345
Practice Address - Country:US
Practice Address - Phone:330-766-1880
Practice Address - Fax:330-637-3320
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.014662225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist