Individual
ETHAN SALATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 CUYLER CT, TOWSON, MD 21204-2412
(410) 935-4587
Mailing address
2 CUYLER CT, TOWSON, MD 21204-2412
(410) 935-4587
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/08/2017
Last updated
04/08/2017
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