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General NPI Number Information
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NPI Number | 1003467630
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Entity Type | Individual
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Provider Name | ETHAN DANIEL LAUNSTEIN PT, DPT, AT, ATC
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Gender | Male
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Dates
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Enumeration Date | 09/25/2019
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 2800 WINSLOW AVE
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City | CINCINNATI
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State | OH
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Zip | 45206-1144
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Country | US
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Telephone | 513-636-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 584 E COLUMBIA RD
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City | MASON
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State | MI
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Zip | 48854-9647
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Country | US
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Telephone | 517-525-1679
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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