Individual
ETHAN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
7707 W DEER VALLEY RD, SUITE 100, PEORIA, AZ 85382-2101
(623) 376-9100
(623) 376-9141
Mailing address
15410 S MOUNTAIN PKWY, SUITE 112, PHOENIX, AZ 85044-6691
(480) 706-1161
(480) 706-7997
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12383
AZ
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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