Individual
ETHAN JOERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5640 HIGHWAY Y, GERALD, MO 63037-1204
(314) 609-1791
Mailing address
5640 HIGHWAY Y, GERALD, MO 63037-1204
(314) 609-1791
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2011040559
MO
Other
Enumeration date
01/27/2016
Last updated
01/27/2016
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