Duffy David Eberhardt
Specialist/Technologist, Athletic Trainer in Ixonia, WI. Individual provider (NPI-1).
NPI number1669961124
StatusActive
Last updated in NPPESMay 9, 2018
Details
- NPI
- 1669961124
- Entity type
- Individual (NPI-1)
- Name
- Duffy David Eberhardt
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 9, 2018
- Last updated
- May 9, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
| 146N00000X | Emergency Medical Technician, Basic | – | – |
Practice location
N7936 Woody LnIxonia, WI 53036-9479
Phone 262-510-8130
Mailing address
N7936 Woody LnIxonia, WI 53036-9479
Phone 262-510-8130
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