Provider Demographics
NPI:1013219013
Name:EHRHARD, JEFFREY (ATC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:EHRHARD
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 SOUTHTOWNE DR
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-2635
Mailing Address - Country:US
Mailing Address - Phone:715-832-1400
Mailing Address - Fax:
Practice Address - Street 1:4212 SOUTHTOWNE DR
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-2635
Practice Address - Country:US
Practice Address - Phone:715-832-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI558039246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other