Individual
MATTHEW ANTALIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
730 W MARKET ST, LIMA, OH 45801-4602
(419) 226-4431
(419) 226-4315
Mailing address
PO BOX 639882, CINCINNATI, OH 45263-9882
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34015164
OH
Other
Enumeration date
03/12/2018
Last updated
07/23/2021
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