Provider Demographics
NPI:1295899474
Name:EAYRS, JEFFREY DAVID (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:DAVID
Last Name:EAYRS
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-5748
Mailing Address - Country:US
Mailing Address - Phone:406-756-8663
Mailing Address - Fax:
Practice Address - Street 1:1500 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-5748
Practice Address - Country:US
Practice Address - Phone:406-756-8663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT25210174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist