Individual
DUSTIN CHASE ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
9905 N DAVIDSON PKWY, STE# 107, STOCKBRIDGE, GA 30281-4200
(770) 424-1421
Mailing address
9905 N DAVIDSON PKWY STE 107, STOCKBRIDGE, GA 30281-4200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR008916
GA
Other
Enumeration date
04/02/2012
Last updated
04/02/2012
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