Individual
ETHAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
252 S 4TH ST, LEBANON, PA 17042-6111
(717) 270-7500
Mailing address
774 KNOLL DR, MOUNT JOY, PA 17552-9411
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/13/2024
Last updated
09/13/2024
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