Individual
MRS. CHRISTINA JOY ETHERIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
127 TARA CT, BENTON, KY 42025-7513
(270) 527-0750
Mailing address
127 TARA CT, BENTON, KY 42025-7513
(270) 527-0750
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
KY
Other
Enumeration date
06/25/2008
Last updated
07/21/2022
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