Individual
MR. JOHN RICHARD ANTONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
4800 S WHITE MOUNTAIN RD, SUITE A, SHOW LOW, AZ 85901-7876
(928) 537-8766
(928) 537-8786
Mailing address
4800 S WHITE MOUNTAIN RD, SUITE A, SHOW LOW, AZ 85901-7876
(928) 537-8766
(928) 537-8786
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2451
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134221
NEAZ
AZ
01
—
19-099814
STATE COMPENSATION FUND
AZ
01
—
6400
HUMANA
AZ
01
—
AZ0298660
BLUE CROSS/ BLUE SHIELD
AZ
01
—
DA4951
RAILROAD MEDICARE
AZ
Enumeration date
09/19/2007
Last updated
10/04/2007
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