Individual
SAMUEL ETHAN HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
17273 OH 104, CHILLICOTHE, OH 45601
(740) 773-1141
Mailing address
2309 MEADOW VILLAGE DR, COLUMBUS, OH 43235-4913
(260) 494-6735
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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