Individual
MR. ETHAN DIAMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
469 E MAPLE AVE, LANGHORNE, PA 19047-1600
(215) 750-4304
Mailing address
469 E MAPLE AVE, LANGHORNE, PA 19047-1600
(215) 750-4304
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TOP009413
PA
Other
Enumeration date
03/29/2024
Last updated
03/29/2024
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