Individual
ETHAN JACOB BABCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 W EMBARGO ST, ROME, NY 13440-3153
(315) 360-8084
Mailing address
600 W EMBARGO ST, ROME, NY 13440-3153
(315) 360-8084
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
—
—
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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