Individual
MR. ETHAN ZACHARY MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
9400 LAKEVIEW PKWY STE 121, ROWLETT, TX 75088-4401
(214) 501-4050
(214) 501-4640
Mailing address
PO BOX 315, ROWLETT, TX 75030-0315
(214) 501-4050
(214) 501-4640
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
2120
TX
224P00000X
Prosthetist
Primary
2120
TX
Other
Enumeration date
04/19/2021
Last updated
04/19/2021
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