Basic Information
| Provider Information | |||||||||
| NPI: | 1366757189 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EASTMAN | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DOM, CCH, L.AC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3411 N 5TH AVE | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850133811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022833484 | ||||||||
| FaxNumber: | 6022645803 | ||||||||
| Practice Location | |||||||||
| Address1: | 3411 N 5TH AVE | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850133811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022833484 | ||||||||
| FaxNumber: | 6022645803 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2010 | ||||||||
| LastUpdateDate: | 08/17/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171100000X | 778 | FL | N | Other Service Providers | Acupuncturist | 171100000X | 614 | AZ | Y | Other Service Providers | Acupuncturist | 175L00000X | 284 | FL | N | Other Service Providers | Homeopath |
No ID Information.