Individual
MR. BROCK ERIC EBBING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
42010 VILLAGE CENTER PLZ STE 100, STONE RIDGE, VA 20105-3036
(703) 542-7921
Mailing address
42010 VILLAGE CENTER PLZ STE 100, STONE RIDGE, VA 20105-3036
(703) 542-7921
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110006624
VA
Other
Enumeration date
04/15/2019
Last updated
04/15/2019
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