Provider Demographics
NPI:1326220831
Name:EASTWOOD, COLIN WADE (DC)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:WADE
Last Name:EASTWOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 WIMBLEDON SQ
Mailing Address - Street 2:SUITE D
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4945
Mailing Address - Country:US
Mailing Address - Phone:757-410-9550
Mailing Address - Fax:757-410-9506
Practice Address - Street 1:109 WIMBLEDON SQ
Practice Address - Street 2:SUITE D
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4945
Practice Address - Country:US
Practice Address - Phone:757-410-9550
Practice Address - Fax:757-410-9506
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor