Individual
MR. MICHAEL C. EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1901 N STATE HIGHWAY 360 STE 410, GRAND PRAIRIE, TX 75050-1431
(817) 652-2924
Mailing address
4908 SPUR RIDGE CT, FORT WORTH, TX 76244-7983
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2081082
TX
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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