Individual
ETHAN GABRIEL BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
105 WAXHAW PROFESSIONAL PARK DR STE B, WAXHAW, NC 28173-5018
(704) 459-4013
Mailing address
4150 CULP RIDGE TRL APT 308, INDIAN LAND, SC 29707-6180
(803) 847-2657
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A8052
NC
Other
Enumeration date
05/04/2023
Last updated
05/04/2023
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