ETHAN ROSS

ELMHURST, IL
NPI1649640996
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist Athletic Trainer
(Licence: IL  096.003466)
Enumeration Date2015-09-30
Last Update Date2015-09-30
Business Address
ETHAN ROSS
966 S FERN AVE
ELMHURST, IL 60126-5307
Phone number: 630-805-1854
Mailing Address
ETHAN ROSS
966 S FERN AVE
ELMHURST, IL 60126-5307
Phone number: 630-805-1854