ETHAN JAMES

EVANSVILLE, IN
NPI1134667900
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy405300000X Prevention Professional
(Licence: IN  36002454A)
Enumeration Date2017-02-01
Last Update Date2017-02-01
Business Address
ETHAN JAMES MAT, ATC
515 READ ST
EVANSVILLE, IN 47710-1739
Phone number: 812-424-9291
Mailing Address
ETHAN JAMES MAT, ATC
2900 CASTLE CMNS UNIT C
NEWBURGH, IN 47630-7108
Phone number: 937-206-3960