Organization
EBS SPORTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY DENNIS EBERLE ATC (ATHLETIC TRAINER / OWNER)
(309) 202-2955
Entity
Organization
Contact information
Practice address
1019 W LAKE AVE, PEORIA, IL 61614-5933
(309) 202-2955
Mailing address
1019 W LAKE AVE, PEORIA, IL 61614-5933
(309) 202-2955
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
11/12/2007
Last updated
11/12/2007
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