Nicole Ethridge, PTA

NPI #1922733484 in Flora, Illinois

Provider Information

NPI Number: 1922733484
Entity Type: Individual
Name: Nicole Ethridge, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Jul 19, 2022
Last Updated: Jul 19, 2022

Practice Location

Address: 701 SHADWELL AVE
City: Flora
State: Illinois
ZIP Code: 62839-2310
Phone: (618) 662-8361

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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