Individual
ETHAN OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, PT
Contact information
Practice address
2777 BRISTOL ST STE B, COSTA MESA, CA 92626-5997
(949) 250-1112
Mailing address
1433 SUPERIOR AVE APT 219, NEWPORT BEACH, CA 92663-6130
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
303687
CA
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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