Individual
ETHAN STONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11 SPELL RD, HAZLEHURST, GA 31539-5341
(912) 253-5179
Mailing address
11 SPELL RD, HAZLEHURST, GA 31539-5341
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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