ETHAN BRODY CLONTZ

CHARLESTON, SC
NPI1275131054
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: SC  3574)
Enumeration Date2020-10-13
Last Update Date2022-05-24
Business Address
Mr. ETHAN BRODY CLONTZ PA-C
171 ASHLEY AVE
CHARLESTON, SC 29425-6483
Phone number: 843-792-1414
Mailing Address
Mr. ETHAN BRODY CLONTZ PA-C
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200
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