CHARLIE ETHERTON

SEVIERVILLE, TN
NPI1700990025
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: TN  PA0842)
Enumeration Date2006-08-17
Last Update Date2020-04-23
Business Address
CHARLIE ETHERTON PAC
1124 FOX MEADOWS BLVD SUITE 2
SEVIERVILLE, TN 37862-6927
Phone number: 865-453-5530
Mailing Address
CHARLIE ETHERTON PAC
1275 DICK LONAS RD
KNOXVILLE, TN 37909-1382
Phone number: 865-584-4747
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