Individual
ETHAN AREL PADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 UNIVERSITY OF NEW MEXICO MSC-10-5610, ALBUQUERQUE, NM 87131-0001
(505) 272-6451
Mailing address
595 W ORCHARD WAY, GILBERT, AZ 85233-5328
(928) 255-3387
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NM
Other
Enumeration date
04/12/2021
Last updated
04/12/2021
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