Individual
MR. ANTHONY JOHN STACHURSKI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1000 W. 27TH ST., HAZLETON, PA 18201
(570) 454-8888
Mailing address
1000 W 27TH ST, HAZLETON, PA 18202-9604
(570) 454-8888
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
PA
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
07/12/2007
Last updated
10/27/2007
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