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Individual
MR. MARK THOMAS EBERLE
Active
Individual
MR. MARK THOMAS EBERLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT006496L
PA
2255A2300X
Athletic Trainer
RT000110A
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015328200004
—
PA
Enumeration date
03/17/2006
Last updated
07/21/2010
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