Individual
BATHSHEBA ETHERIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
128 PASQUIN DRIVE, EAST STROUDSBURG, PA 18301
(570) 236-4989
(570) 730-4022
Mailing address
128 PASQUIN DRIVE, EAST STROUDSBURG, PA 18301
(570) 236-4989
(570) 730-4022
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
057541011
NY
Other
Enumeration date
09/01/2015
Last updated
09/01/2015
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