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1922733484
NICOLE ETHRIDGE
FLORA, IL
NPI
1922733484
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
Enumeration Date
2022-07-19
Last Update Date
2022-07-19
Business Address
NICOLE ETHRIDGE PTA
701 SHADWELL AVE
FLORA, IL 62839-2310
Phone number: 618-662-8361
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Mailing Address
NICOLE ETHRIDGE PTA
11121 E CANDLEBERRY AVE
EFFINGHAM, IL 62401-7456
Phone number: 618-363-8594
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