Individual
ETHAN THOMAS CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
7250 STATE AVE, KANSAS CITY, KS 66112-3003
(913) 288-7511
Mailing address
2407 N FRANKFORD AVE, LUBBOCK, TX 79416-9643
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
328474
LA
Other
Enumeration date
09/30/2019
Last updated
05/04/2023
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