Individual
ETHAN KLEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
319 W TOWN PL, SUITE 5, ST AUGUSTINE, FL 32092-3101
(904) 342-5262
Mailing address
319 W TOWN PL, SUITE 5, ST AUGUSTINE, FL 32092-3101
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
23511
FL
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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