Individual
ALEX ETZENHOUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
257 COTTONWOOD ST, DELTA, CO 81416-4400
(970) 874-6111
Mailing address
PO BOX 540640, NORTH SALT LAKE, UT 84054-0640
(801) 987-8600
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0015265
CO
Other
Enumeration date
03/07/2023
Last updated
03/07/2023
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