Individual
CARL ANTONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
3811 SPRING ST, MOUNT PLEASANT, WI 53405-1667
(262) 945-3667
Mailing address
3811 SPRING ST, MOUNT PLEASANT, WI 53405-1667
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2011-39
WI
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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