Individual
NATHAN JOHN ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5330 S HIGHWAY 95, FORT MOHAVE, AZ 86426-9225
(928) 788-2273
Mailing address
5330 ARIZONA 95, FT MOHAVE, AZ 86426
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5750
AZ
Other
Enumeration date
07/21/2014
Last updated
10/26/2021
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