Individual
ANITA ETHEREDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
Mailing address
126 SLATE RUN, DOUGLASSVILLE, PA 19518-9250
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
10008402
PA
Other
Enumeration date
10/22/2008
Last updated
10/22/2008
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