Individual
ETHAN ZACHARIAH MERROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1701 MULBERRY LAKE DRIVE, DACULA, GA 30019
(770) 712-4910
Mailing address
1701 MULBERRY LAKE DR, DACULA, GA 30019-4642
(770) 712-4910
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390200000X
CHRIS LINKER ATC LAT
—
Enumeration date
09/20/2017
Last updated
07/21/2022
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