MEDICARE: THOMAS EBEL ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	148	MT

General Provider Information

NPI Number	:	1578068748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS EBEL ATC

Provider Business Mailing Address
First Line	:	1163 TOOLE CT
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59105-2233
Country	:	US
Telephone Number	:	140-669-8048
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 UNIVERSITY DR
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59101-0245
Country	:	US
Telephone Number	:	406-896-5941
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2018
Last Update Date	:	03/28/2018

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