Individual
MR. ETHAN W DISPOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
200 SANFORD RD, WELLS, ME 04090-5534
(973) 600-3147
Mailing address
88 BUENA VISTA DR, RINGWOOD, NJ 07456-2028
(973) 600-3147
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT960
ME
Other
Enumeration date
08/12/2025
Last updated
08/12/2025
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