Healthcare Provider Details

I. General information

NPI: 1831010362
Provider Name (Legal Business Name): TONNA GUINN FREDRICK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 1ST AVE N STE B
ESCANABA MI
49829-1448
US

IV. Provider business mailing address

N17511 ORO LANE H.5
POWERS MI
49874-9685
US

V. Phone/Fax

Practice location:
  • Phone: 906-233-9390
  • Fax: 906-233-9398
Mailing address:
  • Phone: 906-399-3026
  • Fax: 906-233-9398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number7501000028
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: