Individual
WESLEY B EBERLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6102 TENNESSEE AVE, FORT CAMPBELL, KY 42223-5940
(270) 956-4594
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
9906
CO
225100000X
Physical Therapist
Primary
PT 28116
FL
225100000X
Physical Therapist
PT00010095
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0210790
L&I
WA
Enumeration date
07/29/2006
Last updated
05/02/2025
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