Individual
AGNES L EBBAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28004 S WESTERN AVE, APT 310, SAN PEDRO, CA 90732-1200
(310) 910-5280
Mailing address
28004 S WESTERN AVE, APT 310, SAN PEDRO, CA 90732-1200
(310) 910-5280
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT40QA01230500
NJ
Other
Enumeration date
01/25/2007
Last updated
05/02/2008
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