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Individual

MR. ETHAN DANIEL LIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AU.D.

Contact information

Practice address
10881 W. ASBURY AVE., SUITE 110, LAKEWOOD, CO 80227
(303) 985-4423
(303) 985-4459
Mailing address
10881 W. ASBURY AVE., SUITE 110, LAKEWOOD, CO 80227
(303) 985-4423
(303) 985-4459

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
030856
OR
231H00000X
Audiologist
Primary
843
CO

Other

Enumeration date
06/16/2016
Last updated
09/20/2018
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