Ethridge, Nicole

Ethridge, Nicole is an individual health care provider with primary practice located at 701 Shadwell Ave , Flora IL 62839-2310. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Ethridge, Nicole can be contacted via phone (618) 662-8361.

Contact Information

Primary practice address
701 Shadwell Ave Flora IL 62839-2310
Phone: (618) 662-8361
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X Illinois

Profile Details

NPI number 1922733484
LBN Legal business name Ethridge, Nicole
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2022
Last updated Jul 19th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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