Provider Demographics
NPI:1821190349
Name:ANTHONY, JAMES JOSEPH (PT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JOSEPH
Last Name:ANTHONY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14821 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-7881
Mailing Address - Country:US
Mailing Address - Phone:636-227-0559
Mailing Address - Fax:636-227-0232
Practice Address - Street 1:14821 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-7881
Practice Address - Country:US
Practice Address - Phone:636-227-0559
Practice Address - Fax:636-227-0232
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO02178225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000025428Medicare ID - Type UnspecifiedPHYSICAL THERAPY