Individual
ETHAN GLENN BOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
279 SUMMIT DR, WATERFORD, MI 48328-3364
(248) 510-0106
Mailing address
818 S LEROY ST, FENTON, MI 48430-2911
(810) 336-1692
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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