Individual
ETHAN BLAKE GAMBREL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1510 CUMBERLAND AVE, MIDDLESBORO, KY 40965-1223
(618) 534-6713
(606) 302-5418
Mailing address
1510 CUMBERLAND AVE, MIDDLESBORO, KY 40965-1223
(618) 534-6713
(606) 302-5418
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
008856
KY
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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