Individual
JODY RYAN EASTWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
100 PEYTON WAY, SUITE 201, CHARLESTON, WV 25309-8572
(304) 720-2005
(304) 720-2009
Mailing address
100 PEYTON WAY, SUITE 201, CHARLESTON, WV 25309-8572
(304) 720-2005
(304) 720-2009
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
844
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001813057
BLUE CROSS BLUE SHIELD WV
WV
Enumeration date
09/11/2006
Last updated
02/06/2008
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