Individual
CARSON LEE ANTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 662-9300
(910) 662-9301
Mailing address
2819 WILLOW ST, WILMINGTON, NC 28405-3051
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06483
NC
Other
Enumeration date
08/24/2016
Last updated
05/27/2021
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