Provider Demographics
NPI:1710493515
Name:EASTMAN, GIA
Entity Type:Individual
Prefix:
First Name:GIA
Middle Name:
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 S MAIN ST APT 3
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-2338
Mailing Address - Country:US
Mailing Address - Phone:614-787-2318
Mailing Address - Fax:
Practice Address - Street 1:518 S MAIN ST APT 3
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-2338
Practice Address - Country:US
Practice Address - Phone:614-787-2318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-17
Last Update Date:2017-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer