Individual
PHILLIP WILLIAM EASTERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
9100 E 46TH ST N, TULSA, OK 74115-1000
(580) 541-6093
Mailing address
3915 W 15TH AVE, STILLWATER, OK 74074-1672
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5729
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346892585
NPI
OK
Enumeration date
07/09/2019
Last updated
06/20/2022
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