Ethan Timothy Boles

NPI #1437896370 in Ada, Oklahoma

Provider Information

NPI Number
1437896370
Entity Type
Individual
Name
Ethan Timothy Boles
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Case Manager/Care Coordinator
Enumeration Date
May 12, 2022
Last Updated
May 12, 2022

Practice Location

Address
1600 S BROADWAY AVE
City
Ada
ZIP Code
74820-8708
Phone
(580) 320-4182

Specialties & Taxonomy Codes

Specialty
Case Manager/Care Coordinator

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