Individual
SHELBY TYRUS ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RT (R) (CT)
Contact information
Practice address
3200 VINE ST, CINCINNATI, OH 45220-2213
(513) 861-3100
Mailing address
3355 BAUERWOOD DR, CINCINNATI, OH 45251-2911
(513) 207-2111
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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