Individual
ETHAN JACK PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4025 OAKWOOD DR APT 422, CHATTANOOGA, TN 37416-2380
(731) 693-9283
Mailing address
4025 OAKWOOD DR APT 422, CHATTANOOGA, TN 37416-2380
(731) 693-9283
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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