Provider Demographics
NPI:1952110124
Name:EFFINGER, ETHAN FREDERICK (DC)
Entity type:Individual
Prefix:DR
First Name:ETHAN
Middle Name:FREDERICK
Last Name:EFFINGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10457 SPRING TIDE WAY
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-2542
Mailing Address - Country:US
Mailing Address - Phone:262-613-9540
Mailing Address - Fax:
Practice Address - Street 1:10457 SPRING TIDE WAY
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-2542
Practice Address - Country:US
Practice Address - Phone:262-613-9540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH15277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor