Provider Demographics
NPI:1780899344
Name:EASTON, CHRIS W (PT)
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:W
Last Name:EASTON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11216 NW EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-8373
Mailing Address - Country:US
Mailing Address - Phone:405-373-3122
Mailing Address - Fax:405-373-3443
Practice Address - Street 1:11216 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-8373
Practice Address - Country:US
Practice Address - Phone:405-373-3122
Practice Address - Fax:405-373-3443
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2407225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200060550AMedicaid
OK200060550AMedicaid