Individual
ETHAN COLE BALDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1789 KIRBY PKWY STE 3, MEMPHIS, TN 38138-3657
(901) 759-1282
(901) 759-1290
Mailing address
1789 KIRBY PKWY STE 3, MEMPHIS, TN 38138-3657
(901) 759-1282
(901) 759-1290
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6559
TN
Other
Enumeration date
09/13/2017
Last updated
09/13/2017
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