Individual
JACQUELINE EBBEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1185 S ADAMS RD, BIRMINGHAM, MI 48009-7101
(248) 988-8098
Mailing address
2964 RIVERSIDE DR, LAKE ORION, MI 48359-1593
(248) 393-0788
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501012496
MI
Other
Enumeration date
05/31/2008
Last updated
05/31/2008
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