Provider Demographics
NPI:1013056670
Name:EASTBURN, NORMAN WILLIAM (DC)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:WILLIAM
Last Name:EASTBURN
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 1:2119 WHITESVILLE ROAD
Mailing Address - Street 2:ATLANTIC CHIRO CARE PC
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-2600
Mailing Address - Country:US
Mailing Address - Phone:732-370-7880
Mailing Address - Fax:732-370-2040
Practice Address - Street 1:2119 WHITESVILLE ROAD
Practice Address - Street 2:ATLANTIC CHIRO CARE PC
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-2600
Practice Address - Country:US
Practice Address - Phone:732-370-7880
Practice Address - Fax:732-370-2040
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00587700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U88698Medicare UPIN
054646Medicare ID - Type Unspecified