Individual
ETHAN JAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4020 EDISON LAKES PKWY, MISHAWAKA, IN 46545-3420
(574) 271-1114
Mailing address
1441 E CHERRY ST, VERMILLION, SD 57069-2602
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004511A
IN
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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