Organization
ETHAN HEALTH LLC
Active
Other names
Ethan Health Lab Services
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER EVANS (OFFICIAL CREDENTIALING MANAGER)
(859) 317-8714
Entity
Organization
Contact information
Practice address
1623 FOXHAVEN DR, RICHMOND, KY 40475-1056
(859) 625-5235
(859) 625-5237
Mailing address
1623 FOXHAVEN DR, RICHMOND, KY 40475-1056
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
12/20/2017
Last updated
12/20/2017
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