Individual
MR. JUSTIN LEE EBERT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-7990
(417) 820-8734
Mailing address
4352 W 2ND ST, BATTLEFIELD, MO 65619-9794
(417) 886-0488
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
119560
MO
Other
Enumeration date
11/02/2005
Last updated
07/08/2007
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