Individual
DR. KEITH ROY EBNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
150 MILESTONE WAY, SUITE A, GREENVILLE, SC 29615-6605
(864) 616-2675
Mailing address
102 NORTH STAGHORN LANE, GREER, SC 29650
(864) 292-0766
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3750
SC
Other
Enumeration date
11/15/2012
Last updated
05/27/2014
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