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1588308571
ETHAN FORT
HAYS, KS
NPI
1588308571
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
Enumeration Date
2022-04-25
Last Update Date
2022-04-25
Business Address
ETHAN FORT
2220 CANTERBURY DR
HAYS, KS 67601-2370
Phone number: 855-429-7633
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Mailing Address
ETHAN FORT
4100 MILLSTONE CIR
HAYS, KS 67601-9797
Phone number: 785-259-2457
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