Provider Demographics
NPI:1497116446
Name:MEMMO, ANTHONY NICHOLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:NICHOLAS
Last Name:MEMMO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W GERMANTOWN PIKE
Mailing Address - Street 2:STE 210
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1420
Mailing Address - Country:US
Mailing Address - Phone:239-263-3330
Mailing Address - Fax:
Practice Address - Street 1:13020 LIVINGSTON RD
Practice Address - Street 2:SUITE 14
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-5021
Practice Address - Country:US
Practice Address - Phone:239-263-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-17
Last Update Date:2019-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011415111N00000X
FLCH11784111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0900XChiropractic ProvidersChiropractorInternist