Individual
DR. ADRIAN PETER EBBEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
222 N MAIN ST, KIMBERLY, WI 54136-1415
(920) 788-5612
(920) 788-0857
Mailing address
222 N MAIN ST, KIMBERLY, WI 54136-1415
(920) 788-5612
(920) 788-0857
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1330035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38568400
—
WI
Enumeration date
12/21/2005
Last updated
07/08/2007
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