Provider Demographics
NPI:1821131491
Name:PRIOR, ANTHONY EUGENE
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:EUGENE
Last Name:PRIOR
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 1:3861 LOFTON PL
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-1809
Mailing Address - Country:US
Mailing Address - Phone:909-625-7207
Mailing Address - Fax:909-626-1524
Practice Address - Street 1:3861 LOFTON PL
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-1809
Practice Address - Country:US
Practice Address - Phone:909-625-7207
Practice Address - Fax:909-626-1524
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner