Individual
ALEXANDER KANTLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12318 BOYDTON PLANK RD, DINWIDDIE, VA 23841-2454
(804) 300-7720
Mailing address
12318 BOYDTON PLANK RD, DINWIDDIE, VA 23841-2454
(804) 300-7720
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/03/2018
Last updated
07/03/2018
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