Provider Demographics
NPI:1932540630
Name:TURNER, TONY RONTICE
Entity Type:Individual
Prefix:MR
First Name:TONY
Middle Name:RONTICE
Last Name:TURNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7352 ROSE TERRACE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-3682
Mailing Address - Country:US
Mailing Address - Phone:980-298-2826
Mailing Address - Fax:
Practice Address - Street 1:7352 ROSE TERRACE CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3682
Practice Address - Country:US
Practice Address - Phone:980-298-2826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7211075171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator