Ethan Timothy Boles
Ethan Timothy Boles is a Case Manager/Care Coordinator in Ada, Oklahoma. Practices as a sole proprietor. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
1600 S Broadway AveAda, OK 74820-8708
Phone: (580) 320-4182
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Specialties & licences
| Case Manager/Care Coordinator (primary) | Taxonomy 171M00000X |
|---|
Record details
| NPI number | 1437896370 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | May 12, 2022 |
| Last updated in NPPES | May 12, 2022 |
| Certification date | May 12, 2022 |
| Mailing address | 1600 S Broadway Ave, Ada, OK 74820-8708 |
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