ETHAN REVIS

LEXINGTON, KY
NPI1699616714
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2026-04-02
Last Update Date2026-04-02
Business Address
Mr. ETHAN REVIS DO
245 FOUNTAIN CT STE 215
LEXINGTON, KY 40509-2792
Phone number: 859-323-6861
Mailing Address
Mr. ETHAN REVIS DO
245 FOUNTAIN CT STE 215
LEXINGTON, KY 40509-2792
Phone number: 859-323-6861
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