ANDREW JACKSON ETHERIDGE

BALTIMORE, MD
NPI1487246369
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy229N00000X Anaplastologist
Additional Taxonomies156FX1700X Technician/Technologist, Ocularist
224900000X Mastectomy Fitter
224L00000X Pedorthist
225000000X Orthotic Fitter
Enumeration Date2021-02-11
Last Update Date2022-08-30
Business Address
ANDREW JACKSON ETHERIDGE CCA, CFo, CFm, CPed
601 N CAROLINE ST FL 6
BALTIMORE, MD 21287-0006
Phone number: 410-955-8215
Mailing Address
ANDREW JACKSON ETHERIDGE CCA, CFo, CFm, CPed
6201 GREENLEIGH AVE
BALTIMORE, MD 21220-2004
Phone number: 410-933-6423
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