Individual
MR. PHILLIP LYNN EASTON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
1130 E WALNUT ST, CARBONDALE, IL 62901-5007
(618) 351-1031
(618) 351-1107
Mailing address
PO BOX 76, TILDEN, IL 62292-0076
(618) 443-7801
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
41300529
IL
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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