NPI 1093078032

Theresa Roseanne Anthony, COTAL

Practitioner Specialist Casper, WY

Practice location

Address: 6570 S Springs Dr, Casper, WY 82604-5496
Phone: (307) 267-8978

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 250098 (WY)

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Registry record

NPI: 1093078032
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Jun 2012
Record last updated: 22 Jun 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.