Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ETHAN LAKE, PT, DPT
ActiveETHAN LAKE, PT, DPT is a Physical Therapy Assistant healthcare provider located in CALERA, Alabama. NPI 1336818301 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · CALERA, AL
Registration Details
- NPI Number
- 1336818301
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 12, 2021 (4.8887410986565 yrs)
- Last Updated
- Nov 12, 2021
- Licenses
-
PTH10621 (AL)1-1177 (AL)
Practice Information
- Address
-
80 HIGHWAY 304CALERA, AL, 350405551Browse AL providers · Browse ZIP 35040
- Phone
- 2056686900
- Fax
- 2056682677
- Primary Specialty
-
Physical Therapy Assistant
225100000X
- Additional Specialty
- Physical Therapy Assistant
Other Physical Therapy Assistant Providers in CALERA, AL
| Name | Credential | NPI |
|---|---|---|
| MRS. CYNTHIA BELL MATTHEWS | MSPT | 1336316439 |
| RYAN HEATH PAYNE | DPT | 1346797800 |
| JOHN ZACHARY EDWARDS | — | 1922536408 |
| ZACHARY SCOTT DEDMAN | PT, DPT | 1750874319 |
| STEVEN CHRISTOPHER FRANKS | PT, DPT | 1447739016 |
| HENRY DAVIS | PT, DPT | 1730840554 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.