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General NPI Number Information
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NPI Number | 1659582294
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Entity Type | Individual
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Provider Name | JASON EBBING PT
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Gender | Male
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 21 E STATE ST
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City | COLUMBUS
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State | OH
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Zip | 43215-4281
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Country | US
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Telephone | 614-366-3600
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Fax | 614-366-3601
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Provider Business Mailing Address
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Address Line | 1180 CHAMBERS RD APT 101C
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City | COLUMBUS
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State | OH
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Zip | 43212-1714
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Country | US
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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 | 10439
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License Number State | OH
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