Provider Demographics
NPI:1639546542
Name:REPPOND, ANTHONY (NSCA-CPT)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:REPPOND
Suffix:
Gender:M
Credentials:NSCA-CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 COLONY CROSSING WAY
Mailing Address - Street 2:STE 660
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6322
Mailing Address - Country:US
Mailing Address - Phone:601-717-2429
Mailing Address - Fax:
Practice Address - Street 1:119 COLONY CROSSING WAY
Practice Address - Street 2:STE 660
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6322
Practice Address - Country:US
Practice Address - Phone:601-717-2429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer