Individual
ETHAN HIGGINBOTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1115 20TH ST, HUNTINGTON, WV 25703-2071
(304) 691-1500
(304) 523-4358
Mailing address
1115 20TH ST, HUNTINGTON, WV 25703-2071
(304) 691-1500
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/19/2023
Last updated
03/14/2025
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