Provider Demographics
NPI:1992820047
Name:HAMILTON, TONUA (PT DPT)
Entity type:Individual
Prefix:DR
First Name:TONUA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 HOLLYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-3103
Mailing Address - Country:US
Mailing Address - Phone:801-635-9447
Mailing Address - Fax:801-272-5009
Practice Address - Street 1:4578 HIGHLAND DR
Practice Address - Street 2:SUITE 190
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-4243
Practice Address - Country:US
Practice Address - Phone:801-272-5008
Practice Address - Fax:801-272-5009
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT118777-2401174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT466514Medicare Oscar/Certification