Healthcare Provider Details

I. General information

NPI: 1174579205
Provider Name (Legal Business Name): ANTHONY ANTICH M.S.,R.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 ONEIDA CT SUITE 100
CHESTER SPRINGS PA
19425-2934
US

IV. Provider business mailing address

4 ONEIDA CT
CHESTER SPRINGS PA
19425-2934
US

V. Phone/Fax

Practice location:
  • Phone: 610-935-3500
  • Fax:
Mailing address:
  • Phone: 610-469-9057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT001384E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-001384-E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: