Provider Demographics
NPI:1003467630
Name:LAUNSTEIN, ETHAN DANIEL (PT, DPT, AT, ATC)
Entity type:Individual
Prefix:DR
First Name:ETHAN
Middle Name:DANIEL
Last Name:LAUNSTEIN
Suffix:
Gender:M
Credentials:PT, DPT, AT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:584 E COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-9647
Mailing Address - Country:US
Mailing Address - Phone:517-525-1679
Mailing Address - Fax:
Practice Address - Street 1:2800 WINSLOW AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1144
Practice Address - Country:US
Practice Address - Phone:513-636-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-25
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program