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ETHAN D ERWIN

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1790357945

Individual Registrant:
 ETHAN D ERWIN 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1801 FOREST HILLS BLVD STE 205  BELLA VISTA, AR 72715-3071 US
Tel: 479-855-9348  Fax: --

Contact information for business:
124 S COLLEGE ST APT 8  MOUNTAIN HOME, AR 72653-3921 US
Tel: 870-405-3435  Fax: --

Registration Information:
NPI: 1790357945
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
AR4646

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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