Individual
ETHAN PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9846 HWY 31 E, TYLER, TX 75705-2329
(903) 592-8001
Mailing address
9846 HWY 31 E, TYLER, TX 75705-2329
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2165035
TX
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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