Individual
ANTHONY COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2535 KETTNER BLVD, SAN DIEGO, CA 92101-1250
(619) 615-0701
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000
—
MO
Enumeration date
03/24/2014
Last updated
05/15/2019
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