Provider Demographics
NPI:1023855947
Name:EASTERLY ENTERPRISES LLC
Entity type:Organization
Organization Name:EASTERLY ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:D.C.
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:EASTERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-224-7079
Mailing Address - Street 1:801 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:TALLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71282-4534
Mailing Address - Country:US
Mailing Address - Phone:318-805-2998
Mailing Address - Fax:318-493-5096
Practice Address - Street 1:801 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:TALLULAH
Practice Address - State:LA
Practice Address - Zip Code:71282-4534
Practice Address - Country:US
Practice Address - Phone:318-935-0899
Practice Address - Fax:318-493-5096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty