Individual
LUCAS R EBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
717 W MORELAND BLVD, WAUKESHA, WI 53188-2432
(262) 542-9100
Mailing address
717 W MORELAND BLVD, WAUKESHA, WI 53188-2432
(262) 542-9100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3784
WI
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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