Provider Demographics
NPI:1982132411
Name:ANTOUN, RAYMOND (ATC)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:ANTOUN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 CAPTAIN EAMES CIR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-1981
Mailing Address - Country:US
Mailing Address - Phone:508-397-0369
Mailing Address - Fax:
Practice Address - Street 1:142 CAPTAIN EAMES CIR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721-1981
Practice Address - Country:US
Practice Address - Phone:508-397-0369
Practice Address - Fax:508-397-0369
Is Sole Proprietor?:No
Enumeration Date:2017-05-29
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program