Organization
SOUTHRIDGE ADVANCED CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JODY R EASTWOOD D.C. (OWNER)
(850) 557-0104
Entity
Organization
Contact information
Practice address
100 PEYTON WAY, SUITE 201, CHARLESTON, WV 25309-8572
(850) 557-0104
Mailing address
100 PEYTON WAY, SUITE 201, CHARLESTON, WV 25309-8572
(850) 557-0104
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
111N00000X
WV
Other
Enumeration date
09/06/2007
Last updated
09/06/2007
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