Most Relevant Information
Provider Data
| NPI Number: | 1003665399 |
| Provider Name: | MADELINE EBERT |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/17/2024 |
| Last Updated: | 05/17/2024 |
Provider Practice Location
8701 WATERTOWN PLANK RD
WAUWATOSA
WI
532263548
Practice Location Phone/Fax
| Phone: | 4149558296 |
| Fax: |
Provider Mailing Location
8701 WATERTOWN PLANK RD
WAUWATOSA
WI
532263548
Provider Mailing Phone/Fax
| Phone: | 4149558296 |
| Fax: |