MEDICARE: MR. ANTHONY ROBERT READER LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	3890-046	WI

General Provider Information

NPI Number	:	1316199557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTHONY ROBERT READER LMT

Provider Business Mailing Address
First Line	:	3387 S KINNICKINNIC AVE
Second Line	:	APT D
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-3187
Country	:	US
Telephone Number	:	414-721-6942
Fax Number	:

Provider Business Practice Location Address
First Line	:	10620 N PORT WASHINGTON RD
Second Line	:
City	:	MEQUON
State	:	WI
Zip	:	53092-5048
Country	:	US
Telephone Number	:	414-721-6942
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	12/08/2011

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