Provider Demographics
NPI:1902695646
Name:CHURCHER, TONISE (LMT)
Entity type:Individual
Prefix:
First Name:TONISE
Middle Name:
Last Name:CHURCHER
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 DENTON TAP RD APT 1526
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8164
Mailing Address - Country:US
Mailing Address - Phone:612-552-8404
Mailing Address - Fax:
Practice Address - Street 1:2801 DENTON TAP RD APT 1526
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8164
Practice Address - Country:US
Practice Address - Phone:612-552-8404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT143647225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist