Individual
LORI KATHERINE EBINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
74 N FISHER PARK WAY, EAGLE, ID 83616
(208) 391-7210
Mailing address
372 S EAGLE RD # 126, EAGLE, ID 83616-5908
(208) 302-6450
(208) 302-6455
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1278
ID
Other
Enumeration date
09/08/2015
Last updated
11/15/2023
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