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1679023345
ETHAN BAILEY
COLUMBUS, IN
NPI
1679023345
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IN 10003274A)
Enumeration Date
2016-10-06
Last Update Date
2024-09-06
Business Address
ETHAN BAILEY PA
2106 25TH ST STE F
COLUMBUS, IN 47201-3238
Phone number: 812-376-5070
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Mailing Address
ETHAN BAILEY PA
PO BOX 775383
CHICAGO, IL 60677-5383
Phone number: 812-376-5315
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