CHARLES EARL ETHERIDGE

ELYRIA, OH
NPI1245759794
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: OH  CDCA.164758)
Enumeration Date2017-09-15
Last Update Date2017-09-15
Business Address
MR. CHARLES EARL ETHERIDGE CDCA
1131 E BROAD ST
ELYRIA, OH 44035-6305
Phone number: 440-365-1900
Mailing Address
MR. CHARLES EARL ETHERIDGE CDCA
1131 E BROAD ST
ELYRIA, OH 44035-6305
Phone number:
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