Doctor Name: | MRS. TONJA J CONNALLY |
NPI Number: | 1043492333 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | MT004420 |
Business Practice Address: | 4935 Stewart Mill Rd Ste 101 Douglasville, GA - 301356733 |
Business Phone Number: | 6788384433 |
Business Fax Number: | 6788384093 |
Mailing Address: | 32 Cliff Ct, VILLA RICA |
State: | GA |
Postal Code: | 301804598 |
Phone Number: | 4047549887 |
Fax Number: | |
NPI Enumeration Date: | 11/29/2007 |
NPI Last Update Date: | 11/29/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT004420 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |