Individual
JUSTIN ANTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
130 JEDDITO COURT, WINDOW ROCK, AZ 86515
(928) 245-5935
Mailing address
PO BOX 2735, WINDOW ROCK, AZ 86515
(928) 245-5935
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
D02067444
AZ
Other
Enumeration date
11/12/2013
Last updated
11/12/2013
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