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General NPI Number Information
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NPI Number | 1386331890
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Entity Type | Individual
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Provider Name | NATHAN EBERHARD
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Gender | Male
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | USNMRTU IWAKUNI, BLDG 110, MCAS IWAKUNI, 1 MISUMI MACHI
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City | IWAKUNI
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State | YAMAGUCHI
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Zip | 7400025
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Country | JP
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Telephone | 859-979-9426
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 561 BOX 1877, FPO AP 96310-0014
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City | IWAKUNI
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State | YAMAGUCHI
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Zip | 7400025
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Country | JP
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1383644
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License Number State | TX
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