Individual
ETHAN SOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 MUTUAL DR, ANDERSON, SC 29621-1767
(864) 261-3313
(864) 261-3371
Mailing address
120 MUTUAL DR, ANDERSON, SC 29621-1767
(864) 261-3313
(864) 261-3371
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8636
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8636
DEPARTMENT OF LABOR, LICENSING AND REGULATION
SC
Enumeration date
07/17/2017
Last updated
07/21/2022
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