Individual
MR. ANTHONY CALVIN BRISCOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.S.,CCC-SLP
Contact information
Practice address
4 BLAKE ST, PRESQUE ISLE, ME 04769-2427
(207) 764-4498
(207) 764-1912
Mailing address
PO BOX 308, PRESQUE ISLE, ME 04769-0308
(207) 764-4498
(207) 764-1912
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP450
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015558
ANTHEM BLUE CROSS
ME
Enumeration date
02/02/2007
Last updated
07/09/2007
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