Individual
ETHAN THAUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
801 5TH ST, SIOUX CITY, IA 51101-1326
(712) 279-2010
Mailing address
327 LAKESHORE DR, NORTH SIOUX CITY, SD 57049-4002
(307) 337-6943
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/15/2022
Last updated
07/15/2022
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