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1750964284
ETHAN JOEL DUDLEY
MARYVILLE, TN
NPI
1750964284
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: TN 13412)
Additional Taxonomies
225100000X Physical Therapist
Enumeration Date
2021-05-03
Last Update Date
2021-05-26
Business Address
ETHAN JOEL DUDLEY
1632 W BROADWAY AVE
MARYVILLE, TN 37801-5600
Phone number: 865-984-1996
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Mailing Address
ETHAN JOEL DUDLEY
PO BOX 306393
NASHVILLE, TN 37230-6393
Phone number: 615-373-1350
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