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1659367035
MARK ETHERIDGE
MOBILE, AL
NPI
1659367035
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: AL 1-080454)
Enumeration Date
2005-09-21
Last Update Date
2017-05-01
Business Address
-- MARK ETHERIDGE CRNA
2451 FILLINGIM ST
MOBILE, AL 36617-2238
Phone number: 251-471-7035
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Mailing Address
-- MARK ETHERIDGE CRNA
5680 SHELBY LN
WILMER, AL 36587-6800
Phone number: 251-645-2529
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