ETHAN MASSINGILL

TYLER, TX
NPI1619665478
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: TX  BP10085240)
Enumeration Date2023-04-28
Last Update Date2023-06-21
Business Address
ETHAN MASSINGILL DO
11937 US HIGHWAY 271
TYLER, TX 75708-3154
Phone number: 903-877-7200
Mailing Address
ETHAN MASSINGILL DO
11937 US HIGHWAY 271
TYLER, TX 75708-3154
Phone number: 903-877-7200