Individual
MR. KENNETH TILLMAN ETHINGTON JR.
Active
Individual
MR. KENNETH TILLMAN ETHINGTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
5477970-2402
UT
2251X0800X
Orthopedic Physical Therapist
5477970-2402
UT
Other
Enumeration date
07/11/2013
Last updated
07/11/2013
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