Individual
RICHARD A EBBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2422 LAKE AVE, ASHTABULA, OH 44004-4985
(440) 998-3376
(440) 997-5751
Mailing address
14381 FORD RD, MADISON, OH 44057-9562
(440) 298-3714
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50000092
OH
Other
Enumeration date
02/16/2007
Last updated
11/06/2007
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