Individual
JOE ANTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
8315 N DENVER AVE, PORTLAND, OR 97217-6707
(503) 583-2686
Mailing address
8315 N DENVER AVE, PORTLAND, OR 97217-6707
(503) 583-2686
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17031
OR
Other
Enumeration date
04/29/2010
Last updated
12/21/2010
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