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1720358807
ANTONIO T BOSTON
MILWAUKEE, WI
NPI
1720358807
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 16231-130)
Enumeration Date
2012-01-06
Last Update Date
2012-01-06
Business Address
-- ANTONIO T BOSTON SAC-IT
2821 N 4TH ST STE 139
MILWAUKEE, WI 53212-2362
Phone number: 414-264-4217
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Mailing Address
-- ANTONIO T BOSTON SAC-IT
2821 N 4TH ST STE 139
MILWAUKEE, WI 53212-2362
Phone number: 414-264-4217
Copy
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