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General NPI Number Information
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NPI Number | 1497116446
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Entity Type | Individual
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Provider Name | ANTHONY NICHOLAS MEMMO D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/17/2016
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Last Update Date | 02/24/2019
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Provider Practice Location Address
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Address Line | 13020 LIVINGSTON RD SUITE 14
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City | NAPLES
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State | FL
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Zip | 34105-5021
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Country | US
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Telephone | 239-263-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 120 W GERMANTOWN PIKE STE 210
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-1420
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Country | US
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Telephone | 239-263-3330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC011415
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | CH11784
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License Number State | FL
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