Individual
MR. ANTHONY MERRELL GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
599 TOMALES RD, HS-A SCHOOL, PETALUMA, CA 94952-5002
(707) 765-7488
Mailing address
599 TOMALES RD, HS-A SCHOOL, PETALUMA, CA 94952-5002
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
11/06/2007
Last updated
11/06/2007
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