Individual
DR. MARK ARTHUR EBBEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD OPTOMETRIST
Contact information
Practice address
1 BANK AVE, KAUKAUNA, WI 54130-2581
(920) 766-2481
(920) 766-3769
Mailing address
1 BANK AVE, KAUKAUNA, WI 54130
(920) 766-2481
(920) 766-3769
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1618035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38700400
—
WI
Enumeration date
05/04/2006
Last updated
03/07/2023
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