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1740064930
WILLIAM ETHAN CHYNOWETH
ROSEVILLE, CA
NPI
1740064930
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: NM PT6146)
Enumeration Date
2023-08-21
Last Update Date
2023-08-21
Business Address
WILLIAM ETHAN CHYNOWETH
2235 DOUGLAS BLVD STE 520
ROSEVILLE, CA 95661-4266
Phone number: 191-677-2719
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Mailing Address
WILLIAM ETHAN CHYNOWETH
8440 N FAWN LAKE RD NE
STACY, MN 55079-3204
Phone number: 505-331-9876
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