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1619665478
ETHAN MASSINGILL
TYLER, TX
NPI
1619665478
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: TX BP10085240)
Enumeration Date
2023-04-28
Last Update Date
2023-06-21
Business Address
ETHAN MASSINGILL DO
11937 US HIGHWAY 271
TYLER, TX 75708-3154
Phone number: 903-877-7200
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Mailing Address
ETHAN MASSINGILL DO
11937 US HIGHWAY 271
TYLER, TX 75708-3154
Phone number: 903-877-7200
Copy
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