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Individual

ETHAN DAVID CLEARY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
11330 MAPLE BROOK DR, LOUISVILLE, KY 40241-2080
(502) 426-2221
(502) 426-2210
Mailing address
1868 PLAUDIT PL STE B, LEXINGTON, KY 40509-2429
(859) 264-0512
(859) 264-0595

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
008569
KY

Other

Enumeration date
06/14/2022
Last updated
08/23/2022
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