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General NPI Number Information
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NPI Number | 1710891387
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Entity Type | Organization
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Legal Business Name | AETHERION LABORATORIES
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 1309 COFFEEN AVE STE 1200
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City | SHERIDAN
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State | WY
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Zip | 82801-5777
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Country | US
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Telephone | 704-517-7091
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Fax |
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Provider Business Mailing Address
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Address Line | 1309 COFFEEN AVE STE 1200
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City | SHERIDAN
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State | WY
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Zip | 82801-5777
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. LIAM MAHONEY
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Credential |
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Telephone | 704-517-7091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State | NULL
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