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DR. MARY JORDAN ANSTEAD PHD
>> Community Health Worker >> Other Service ProvidersRegistrant NPI Number: 1518316058
Individual Registrant:DR. MARY JORDAN ANSTEAD PHD
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
32007 HARTMAN RD SAN ANTONIO, FL 33576-8175 US
Tel: 813-618-0157 Fax: --
Tel: 813-618-0157 Fax: --
Contact information for business:
PO BOX 338 SAN ANTONIO, FL 33576-0338 US
Tel: 813-618-0157 Fax: --
Tel: 813-618-0157 Fax: --
Registration Information:
NPI: 1518316058
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 172V00000X | Other Service Providers Community Health Worker |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
