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General NPI Number Information
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NPI Number | 1548367998
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Entity Type | Individual
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Provider Name | CHRISTOPHER RYAN EBBERTS ATC, PES
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 700 ARGOSY PKWY
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City | RIVERSIDE
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State | MO
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Zip | 64150-1512
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Country | US
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Telephone | 816-505-4408
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Fax | 816-241-0551
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Provider Business Mailing Address
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Address Line | 10219 N LAWN AVE
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City | KANSAS CITY
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State | MO
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Zip | 64156-3005
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Country | US
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Telephone | 816-668-2151
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2004023137
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License Number State | MO
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