Individual
ANTHONY SCHUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070016473
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00918646
RR MEDICARE PTAN
IL
Enumeration date
07/08/2008
Last updated
05/27/2011
Update your record
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