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Individual

ANTHONY HALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
233 W PLEASANT ST, SPRINGFIELD, OH 45506-2146
(937) 324-5371
(937) 324-4608
Mailing address
2398 BRIGGS RD, CENTERVILLE FINANCE, OH 45459-6621
(937) 435-9781

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20311
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0159644
OH
01
201115007026
CARESOURCE
Enumeration date
03/06/2007
Last updated
07/08/2007
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