Individual
DR. ETHAN ALDON TALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
3630 S 25TH E, SUITE 4, AMMON, ID 83401
(208) 970-4833
Mailing address
2230 PTARMIGAN WAY, AMMON, ID 83401-5898
(208) 970-4833
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2071597
ID
Other
Enumeration date
04/03/2026
Last updated
04/03/2026
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