Individual
ETHAN POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1515 S 1100 E, SALT LAKE CITY, UT 84105-2424
(801) 583-5692
Mailing address
1515 S 1100 E, SALT LAKE CITY, UT 84105-2424
(801) 583-5692
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13433896-2401
UT
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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