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Individual

ETHAN THOMAS PRAVETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT, CCI

Contact information

Practice address
7 CARNEGIE PLZ, CHERRY HILL, NJ 08003-1000
(877) 407-3422
Mailing address
1086 AMSTERDAM AVE APT 2A, NEW YORK, NY 10031

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
040.0124005
VT
225100000X
Physical Therapist
Primary
042312-1
NY
225100000X
Physical Therapist
22214
MA
225100000X
Physical Therapist
4111
NH

Other

Enumeration date
07/06/2016
Last updated
04/16/2020
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