Individual
KRISTILYN EBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
904 ISAAC ST, OREGON, OH 43616-3204
(419) 691-2483
Mailing address
904 ISAAC ST, OREGON, OH 43616-3204
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.09083
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3090284
—
OH
Enumeration date
11/05/2013
Last updated
11/05/2013
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