Provider Demographics
NPI:1649264094
Name:ZALOGA, ANTHONY J (ATC)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:J
Last Name:ZALOGA
Suffix:
Gender:M
Credentials:ATC
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Mailing Address - Street 1:91 PINE ST
Mailing Address - Street 2:
Mailing Address - City:FROSTBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21532-1648
Mailing Address - Country:US
Mailing Address - Phone:301-687-4497
Mailing Address - Fax:301-687-4780
Practice Address - Street 1:101 BRADDOCK RD
Practice Address - Street 2:FROSTBURG STATE UNIVERSITY
Practice Address - City:FROSTBURG
Practice Address - State:MD
Practice Address - Zip Code:21532-2303
Practice Address - Country:US
Practice Address - Phone:301-687-4497
Practice Address - Fax:301-687-4780
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD2255A2300X SPECIALIS2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer