Provider Demographics
NPI:1861791600
Name:POPE, ANTHONY A
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:A
Last Name:POPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 N MICHAEL WAY
Mailing Address - Street 2:APT A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-4101
Mailing Address - Country:US
Mailing Address - Phone:608-213-2994
Mailing Address - Fax:
Practice Address - Street 1:3109 N MICHAEL WAY
Practice Address - Street 2:APT A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-4101
Practice Address - Country:US
Practice Address - Phone:608-213-2994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner