Individual
ETHAN TYLER MAHAFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1350 S KINGS DR FL 3, CHARLOTTE, NC 28207-2134
(704) 446-1242
(704) 446-1241
Mailing address
2010 COUNTRY TRACE LANE, APT 11E, TOLEDO, OH 43615
(419) 450-7079
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/04/2025
Last updated
04/04/2025
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