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Individual

MICHAEL EATON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
955 LANE AVE STE 201, CHULA VISTA, CA 91914-4525
(619) 421-9521
Mailing address
885 CANARIOS CT STE 110, CHULA VISTA, CA 91910-7877
(619) 656-5102

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT292907
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT292907
PT LICENSE
CA
Enumeration date
03/06/2017
Last updated
01/05/2023
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