Organization
EAGLE HEALTHY LIVING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM RODNEY BRYANT (CHIEF EXECUTIVE OFFICER)
(708) 692-2903
Entity
Organization
Contact information
Practice address
16057 SCHOOL ST, SOUTH HOLLAND, IL 60473-1630
(708) 692-2903
Mailing address
16057 SCHOOL ST, SOUTH HOLLAND, IL 60473-1630
(708) 692-2903
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
309007616
IL
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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