Provider Demographics
NPI:1316199557
Name:READER, ANTHONY ROBERT (LMT)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:ROBERT
Last Name:READER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:MR
Other - First Name:ROB
Other - Middle Name:
Other - Last Name:READER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:3387 S KINNICKINNIC AVE
Mailing Address - Street 2:APT D
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-3187
Mailing Address - Country:US
Mailing Address - Phone:414-721-6942
Mailing Address - Fax:
Practice Address - Street 1:10620 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-5048
Practice Address - Country:US
Practice Address - Phone:414-721-6942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3890-046174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist