Individual
MR. ETHAN DANIEL PIERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
710 PARK CENTER DR STE 200, MATTHEWS, NC 28105-5082
(704) 323-3208
Mailing address
4601 PARK RD STE 300, CHARLOTTE, NC 28209-2290
(704) 323-3611
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P21599
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0397730030
NSC#
NC
Enumeration date
08/29/2022
Last updated
12/17/2024
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