Provider Demographics
NPI:1881885358
Name:LATHROP, ANTHONY JAMES (LMT)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JAMES
Last Name:LATHROP
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10922
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-0922
Mailing Address - Country:US
Mailing Address - Phone:808-283-9108
Mailing Address - Fax:
Practice Address - Street 1:505 FRONT ST
Practice Address - Street 2:LEI SPA
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-1187
Practice Address - Country:US
Practice Address - Phone:808-283-9108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8754172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist