Individual
TERI ANTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
400 MIDDLE RD, NANTICOKE, PA 18634-3821
(570) 788-7321
(570) 788-7267
Mailing address
686 MAIN RD, HUNLOCK CREEK, PA 18621-3811
(570) 542-7931
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OC00007132L
PA
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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