Individual
THEODORE L STILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5100 W TILGHMAN ST STE 315, ALLENTOWN, PA 18104-9166
(610) 395-4044
(610) 395-5693
Mailing address
PO BOX 783497, PHILADELPHIA, PA 19178-3497
(610) 395-4044
(610) 395-5693
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN262041L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101812002
—
PA
Enumeration date
04/18/2006
Last updated
12/19/2020
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