Provider Demographics
NPI:1164744215
Name:EBERHARDT, WHITNEY ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:ELIZABETH
Last Name:EBERHARDT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:MEDIAPOLIS
Mailing Address - State:IA
Mailing Address - Zip Code:52637-0404
Mailing Address - Country:US
Mailing Address - Phone:309-255-2008
Mailing Address - Fax:319-394-3239
Practice Address - Street 1:317 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:MEDIAPOLIS
Practice Address - State:IA
Practice Address - Zip Code:52637-7740
Practice Address - Country:US
Practice Address - Phone:309-255-2008
Practice Address - Fax:319-394-3239
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.017611225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist