Individual
ETHAN COVALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
403 6TH ST, BOX 870, HUNTINGDON, PA 16652-1518
(877) 312-6576
Mailing address
560 MAIN LINE DR, LEWISTOWN, PA 17044-8127
(717) 462-0372
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI004324
PA
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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