Individual
TAMMY LYNN EBBEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 731-4101
Mailing address
N8183 BIG LAKE LN, SHERWOOD, WI 54169-9666
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
WI
Other
Enumeration date
09/18/2018
Last updated
10/22/2018
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