Individual
SHELBY TYRUS ETHRIDGE
Active
Individual
SHELBY TYRUS ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RT (R) (CT)
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R8859300
OH
Other
Enumeration date
05/08/2018
Last updated
05/08/2018
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