Provider Demographics
NPI:1851411995
Name:EASTBURN, CHERYL LYNN (ACMT, ANMT)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LYNN
Last Name:EASTBURN
Suffix:
Gender:F
Credentials:ACMT, ANMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9488 N PALOMINO DR
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-9223
Mailing Address - Country:US
Mailing Address - Phone:303-905-4048
Mailing Address - Fax:303-792-9876
Practice Address - Street 1:9488 N PALOMINO DR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-9223
Practice Address - Country:US
Practice Address - Phone:303-905-4048
Practice Address - Fax:303-792-9876
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist