Individual
DUFFY DAVID EBERHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
N7936 WOODY LN, IXONIA, WI 53036-9479
(262) 510-8130
Mailing address
N7936 WOODY LN, IXONIA, WI 53036-9479
(262) 510-8130
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
—
—
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/09/2018
Last updated
05/09/2018
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