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1740018019
ETHAN O'HEARN
VALRICO, FL
NPI
1740018019
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: FL PTA29120)
Enumeration Date
2024-07-26
Last Update Date
2024-07-26
Business Address
ETHAN O'HEARN PTA
1586 BLOOMINGDALE AVE
VALRICO, FL 33596-6101
Phone number: 813-978-9700
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Mailing Address
ETHAN O'HEARN PTA
13020 N TELECOM PKWY
TEMPLE TERRACE, FL 33637-0915
Phone number: 813-978-9700
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