Provider Demographics
NPI:1912059197
Name:SILVA, ANTHONY DAVID (ATC)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:DAVID
Last Name:SILVA
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1200 UNIVERSITY ST
Mailing Address - Street 2:UNIT 9430
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57799-9430
Mailing Address - Country:US
Mailing Address - Phone:605-642-6001
Mailing Address - Fax:605-642-6539
Practice Address - Street 1:1200 UNIVERSITY ST
Practice Address - Street 2:UNIT 9430
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57799-9430
Practice Address - Country:US
Practice Address - Phone:605-642-6001
Practice Address - Fax:605-642-6539
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD00432255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer