Individual
ETHAN EDRED BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1360 N MAIN ST, BISHOP, CA 93514-3013
(760) 872-4573
Mailing address
1360 N MAIN ST, BISHOP, CA 93514-3013
(760) 872-4573
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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