Individual
ETHAN ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2270 US HIGHWAY 17, RICHMOND HILL, GA 31324-3669
(352) 201-4964
Mailing address
2270 US HIGHWAY 17, RICHMOND HILL, GA 31324-3669
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
034630
GA
Other
Enumeration date
11/24/2023
Last updated
11/24/2023
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