Individual
ETHAN CARLOS GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
999 ROUTE 73 N FL 4, MARLTON, NJ 08053-1227
(856) 821-6372
(856) 821-6339
Mailing address
2906 GOOD INTENT RD, WOODBURY, NJ 08096-4458
(856) 834-4839
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA02289100
NJ
Other
Enumeration date
09/16/2024
Last updated
09/16/2024
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