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Individual

ETHAN LOUIS DUCLOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
3507 STATE ROUTE 3, RED BUD, IL 62278-4037
(618) 977-7415
Mailing address
3507 STATE ROUTE 3, RED BUD, IL 62278-4037
(618) 977-7415

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Enumeration date
01/08/2021
Last updated
01/08/2021
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