Individual
ETHAN E PARISEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
22 CARROLL AVE, JACKSON, OH 45640-1105
(740) 418-3315
Mailing address
22 CARROLL AVE, JACKSON, OH 45640-1105
(740) 418-3315
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.025271
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33.025271
OHIO MEDICAL BOARD
OH
Enumeration date
01/29/2021
Last updated
01/29/2021
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