Individual
DAVID ETHAN EBBECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, MBA
Contact information
Practice address
8551 RIXLEW LN, SUITE 340, MANASSAS, VA 20109-4277
(703) 368-7343
(703) 368-0719
Mailing address
8551 RIXLEW LN, SUITE 340, MANASSAS, VA 20109-4277
(703) 368-7343
(703) 368-0719
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305005642
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q395-0002
CAREFIRST BLUE CROSS AND BLUE SHIELD
MD
Enumeration date
07/27/2006
Last updated
11/06/2014
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