Individual
JEFFREY EBENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2711 FOX HILL DR, WAUKESHA, WI 53189-6844
(262) 424-0197
(414) 386-5135
Mailing address
2711 FOX HILL DR, WAUKESHA, WI 53189-6844
(262) 424-0197
(414) 386-5135
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
M090327
WI
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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