Individual
ETHAN FORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2220 CANTERBURY DR, HAYS, KS 67601-2370
(855) 429-7633
Mailing address
4100 MILLSTONE CIR, HAYS, KS 67601-9797
(785) 259-2457
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/25/2022
Last updated
04/25/2022
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