Provider Demographics
NPI:1851447577
Name:SONYA A. TOURVILLE
Entity Type:Organization
Organization Name:SONYA A. TOURVILLE
Other - Org Name:MONTROSE FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOURVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-675-3121
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:
Mailing Address - Fax:
Practice Address - Street 1:145 NELSON BLVD #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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3K700MOOtherBCBS
MNC03470Medicare ID - Type UnspecifiedMEDICARE