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Individual

JOHN EBSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICAL THERAPY

Contact information

Practice address
103 E MAIN ST, RIPON, CA 95366-2416
(209) 599-7073
(209) 599-7074
Mailing address
2406 FREMONT AVE, MODESTO, CA 95350-2288
(209) 404-6674

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT1743
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ZZZ18198Z
PTAN
CA
Enumeration date
11/04/2015
Last updated
11/04/2015
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