Individual
ETHAN JOHN STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
207 S BURLINGTON AVE, HASTINGS, NE 68901-5905
(402) 462-8824
(402) 462-8017
Mailing address
207 S BURLINGTON AVE, HASTINGS, NE 68901-5905
(402) 462-8824
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3082
NE
Other
Enumeration date
08/02/2013
Last updated
02/22/2023
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