NPI 1114061256 · live from the CMS NPI Registry
Kenneth A Ethier, O.D.
Optometrist in Great Falls, MT. National Provider Identifier 1114061256, active.
NPI record
| NPI | 1114061256 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1525 10th Ave S, Great Falls, MT 59405 |
| Practice phone | 406-791-5139 |
| Mailing address | 1025 10th Avenue South, Great Falls, MT 59405 |
| Enumerated | February 19, 2007 |
| Last updated | October 27, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 751 (MT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.