Individual
ETHAN DIONNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
354 MERRIMACK ST STE 1, LAWRENCE, MA 01843-1755
(978) 687-2321
(978) 722-7239
Mailing address
354 MERRIMACK ST STE 1, LAWRENCE, MA 01843-1755
(978) 687-2321
(978) 722-7239
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA5740
MA
363AS0400X
Surgical Physician Assistant
Primary
PA5740
MA
Other
Enumeration date
06/07/2016
Last updated
11/29/2016
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