Individual
ETHAN RICHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
130 MORRIS RD, CIRCLEVILLE, OH 43113-1362
(740) 477-6511
(740) 477-6888
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
(740) 477-6511
(740) 477-6888
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.007619RX
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/24/2022
Last updated
11/09/2022
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