Provider Demographics
NPI:1902292642
Name:STAINBROOK-HAMMOND, TONYA
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:STAINBROOK-HAMMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50488 COUNTY ROAD 673
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MI
Mailing Address - Zip Code:49064-9022
Mailing Address - Country:US
Mailing Address - Phone:269-363-2817
Mailing Address - Fax:
Practice Address - Street 1:50488 COUNTY ROAD 673
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MI
Practice Address - Zip Code:49064-9022
Practice Address - Country:US
Practice Address - Phone:269-363-2817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other