Individual
EAGLEBEAR EASTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
214 N BLISS AVE, TAHLEQUAH, OK 74464-2520
(539) 234-3785
Mailing address
314 REDBUD LN, TAHLEQUAH, OK 74464-5132
(539) 234-3785
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
02/28/2023
Last updated
02/28/2023
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