Individual
ETHAN SPORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
619 N BROADWAY ST, PITTSBURG, KS 66762-3904
(620) 238-8195
Mailing address
619 N BROADWAY ST, PITTSBURG, KS 66762-3904
(620) 238-8195
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
000000
KS
Other
Enumeration date
08/10/2023
Last updated
08/10/2023
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