Provider Demographics
NPI:1174357149
Name:STRICKLAND, ETHAN
Entity type:Individual
Prefix:
First Name:ETHAN
Middle Name:
Last Name:STRICKLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 25TH ST SW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44706-5616
Mailing Address - Country:US
Mailing Address - Phone:614-981-6611
Mailing Address - Fax:
Practice Address - Street 1:215 25TH ST SW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44706-5616
Practice Address - Country:US
Practice Address - Phone:614-981-6611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health