Individual
MRS. THERESA ROSEANNE ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6570 S SPRINGS DR, CASPER, WY 82604-5496
(307) 267-8978
Mailing address
6570 S SPRINGS DR, CASPER, WY 82604-5496
(307) 267-8978
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
250098
WY
Other
Enumeration date
06/22/2012
Last updated
06/22/2012
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