Individual
ANTONIO BOSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2805 N CHAMBERLAIN AVE, CHATTANOOGA, TN 37406-3902
(423) 402-1251
Mailing address
2805 N CHAMBERLAIN AVE, CHATTANOOGA, TN 37406-3902
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
12/31/2019
Last updated
12/31/2019
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